The major cause appears to be cytokine excess. Other potential mediators include testosterone and insulin-like growth factor I deficiency, excess myostatin, and excess glucocorticoids.

Numerous diseases can result in cachexia, each by a slightly different mechanism. 1

It can be a sign of various underlying disorders such adverse drug reactions, cancer, metabolic acidosis, certain infectious diseases (e.g., tuberculosis, AIDS), chronic pancreatitis and some autoimmune disorders.

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It is a risk factor for death.

Cachexia causes weight loss and increased mortality.

Cachexia physically weakens patients to a state of immobility stemming from loss of appetite, asthenia and anemia, and response to standard treatment is usually poor. Cachexia includes sarcopenia as a part of its pathology.




Both nutritional support and orexigenic agents play a role in the management of cachexia.





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A 68-year-old man has a long history of prostate cancer that was metastatic at the time of diagnosis. Over the past 2 months, he has had significant weight loss, loss of appetite, and loss of energy. His current spectrum of conditions can be attributed to which of the following?


    A. Platelet-derived growth factor


    B. Fibroblast growth factor


    C. Interleukin-2


    D. TNF-α


    E. Vascular endothelial growth factor

The answer is D. Cachexia, or wasting due to cancer, manifests with weakness, weight loss, anorexia, anemia, and infection. The principal cytokine responsible for such changes is TNF-α. Both platelet-derived growth factor and fibroblast growth factor are involved in wound healing. Interleukin 2 is an immunostimulating cytokine produced by activated T cells. Vascular endothelial growth factor is important in the proliferation of blood vessels in a growing tumor. 



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