Cachexia

Cachexia – General Information

Cachexia means physical wasting with weight loss, muscle mass loss and atrophy, fatigue, loss of appetite and weakness which are caused by a disease. It usually develops in patients, who are suffering from advanced cancer, major chronic progressive disease (such as COPD – meaning chronic obstructive pulmonary disease, especially emphysema), from infectious diseases such as AIDS and tuberculosis, and autoimmune disease, congestive heart failure, schizophrenia (in this cases the disease is named vesanic Cachexia), but it also develops in persons who are drug addicts and they consume cocaine or amphetamine. Cachexia is a wasting syndrome which usually develops among with anorexia (lack of appetite) and appears in persons who although are eating well their organism can not absorb the nutriments and vitamins. At the time the way in which these disease lead to this medical disorder is not fully understood, but it is thought to be related to the inflammatory cytokines (like tumor necrosis factor alpha, also abbreviated TNF- α, Interferon Gamma and Interleukin 6) and to the tumors which secrete proteolysis inducing factor. The related malnutrition syndromes include kwashiorkor (this is a malnutrition disease which appears in persons who have poor intake of proteins) and marasmus (also a malnutrition problem caused by the lack of protein intake). These two diseases are usually asymptomatic.

Cachexia – Symptoms

It is well known the fact that any medical disorder (including Cachexia) can trigger a variety of symptoms. Therefore, some of this medical condition's most uncommon symptoms have not been listed (mentioned) here. This is why we strongly recommend you to contact your personal health care provider whenever you develop any unusual, bothersome or unpleasant symptoms. Your personal physician will be able to tell you if you are suffering from Cachexia or from any other medical disorder. Here is a list of the most common symptoms that a person who suffers from Cachexia, may experience: loss of weight, muscle atrophy (especially the skeletal muscles), fatigue, weakness which leads to the state of immobility stemming, loss of appetite, asthenia, anemia. If this disease is caused by a rheumatoid arthritis, then the patient can experience: low grade fever, muscle aches and stiffness, joint aches and stiffness, red, painful, tender and swollen joints, damage to the body tissues, bones and cartilage, weakness of the bones, when the cricoarytenoid joint is affected it may lead to a hoarseness of the voice, blood vessel inflammation (which is also known as vasculitis), pericarditis (this is the inflammation of the tissue which surrounds the heart). When the disease is caused by the Reiter’s Syndrome, the patients can experience the following: urogenital tract symptoms, joint symptoms (such as spondylitis or enthesopathy) or arthritis, eye involvement (such as Conjunctivitis and Uveitis which usually lead to the redness of the eye, eye irritation and pain, blurred vision), aortic regurgitation.  

Cachexia – Treatment

The treatment of Cachexia usually should be directed to treating the underlying cause and to controlling the symptoms of this medical disorder. In order to treat the underlying causes for example the rheumatological diseases, the treatment must try to keep the period when the patient is asymptomatic and to try to suppress the acute flare up of the symptoms. This can be achieved by treating the person who is suffering from this medical disorder by prescribing her steroid drugs such as prednisolone.  In the case when the cause of this disease is the Reiter’s Syndrome the patient will be prescribed non-steroidal anti-inflammatory drugs (also abbreviated NSAIDs) which reduce the pain and swelling of the affected joint. If the underlying cause is the ankylosing spondylitis the patient will also be treated with nonsteroidal anti-inflammatory drugs because they can treat the pain and stiffness of the joints.

When the underlying cause is the psoriatic arthritis the treatment prescribed is also based on the nonsteroidal anti-inflammatory drugs such as naproxen, diclofenac, but the joint injections with corticosteroids can be another treatment option or immunosppressants (such as Methotrexate). The bad news is that there is no cure for the Polymyositis – which can also be an underlying cause of the Cachexia. The only treatments related to the Polymyositis can only help the patient to improve the muscle strength. In the cases when the Cachexia is caused by scleroderma the medications which can be prescribed to the patients include: calcium channel blockers, low-dose enteric coated aspirin, alpha blockers, angiotensin – converting enzyme, angiotensin receptor blockers, hydroxychloroquine, penicillamine, cyclophosphamide, bosentan. In the case of the Sjogren’s syndrome, the treatment includes nonsteroidal anti-inflammatory drugs, corticosteroids, hydroxychloroquine, cevimeline, cyclosporines, and immunosuppressants.

In order to control the symptoms of Cachexia there are a few treatment options. The first one is to improve the patient’s nutrition and to calm the inflammatory response which eats up the organism’s energy. For this step the patient should have a high intake of calories, should take drugs which stimulate the appetite and the body to build up muscle mass and also to take anti-inflammatory drugs. There exist other treatments which are still tested, the principle remaining the one listed above. As we already said the treatment is based very much on the underlying disease which leads to Cachexia, this is why it is important for the doctor to establish the correct diagnostic in order to prescribe the precise treatment.