Cachexia
Cachexia is an extreme exhaustion of the body, provoked by various diseases. With cachexia, there is a sharp weight loss, general weakness, a slowdown in physiological processes, and the mental state of the patient changes.
CAUSES OF CACHEXIA
Cachexia usually develops due to diseases, lack of food, severe fatigue.
Among the main reasons provoking cachexia, the following are distinguished:
diseases of the gastrointestinal tract, in which it is difficult for food to enter the stomach, its digestion and absorption of nutrients;
fasting or prolonged malnutrition (including anorexia nervosa);
metabolic disorders (for example, amyloidosis – a violation of protein metabolism), hypofunction of the adrenal glands and thyroid gland;
prolonged intoxication (for example, with chronic tuberculosis), purulent processes in the body;
severe forms of heart failure;
hypoxia in children;
oncological diseases;
AIDS.
CLASSIFICATION OF CACHEXIC STATES
Cachexia in sick lists is most often indicated by the R64 code according to the ICD-10 classification, which refers to the section “General symptoms and signs”, since cachexia does not manifest itself as an independent disease, but is a consequence of other pathological processes.
There are several varieties of cachexia, depending on the reasons for its origin. Pituitary and cerebral cachexia are the result of brain disorders (pituitary and hypothalamus). At the same time, the violations themselves may have different etiologies. Alimentary cachexia is the result of prolonged malnutrition or starvation. Malignant cachexia develops in cancer patients. Cardiac cachexia is the result of chronic heart failure (CHF), occurring in severe form. In addition, senile cachexia is singled out in a separate category.
There is another classification of cachexia, depending on the direction of the factor that provoked it.
Cachexia of exogenous origin is exhaustion provoked by external factors: the influence of the external environment, lack of nutrition, starvation (including for religious reasons or for the purpose of losing weight).
Cachexia of endogenous origin is exhaustion provoked by internal causes, malfunctions in the body. This includes cachexia, which are the result of chronic diseases, metabolic disorders, pathologies of the endocrine system, senile involution, injuries.
In modern medicine, it is customary to distinguish three forms of this disease.
In the hypothalamic form of cachexia, the synthesis of peptides in plasma stops or worsens. As a result, metabolic processes are suppressed, synthesis is disrupted and the transport of fats is suppressed, protein metabolism is disrupted.
With the cachectin form of cachexia, the production of cachectin (TNF-a, TNF – non-glycolized protein that has a cytotoxic effect on tumor cells) significantly increases. Such a violation is usually a consequence of tuberculosis or oncological diseases. As a result, the patient’s appetite decreases, frequent emotional breakdowns are observed, the synthesis of neuropeptides (proteins regulating physiological functions) is disrupted.
In the anorexic form of the disease, the absorption processes in the small intestine are disrupted, neoplasms grow, the function of the adrenal cortex decreases, the sugar content in the blood drops.
SYMPTOMS OF CACHEXIA
Due to the complex etiology of the disease, the symptoms of cachexia can manifest in different ways, but in general, the main signs are as follows:
sudden weight loss (in severe cases, the patient may lose about 50% of body weight), dehydration, loss of fat cells, protein-free edema;
reduction of subcutaneous tissue and circulating blood volume (the latter can cause amenorrhea in women – prolonged absence of menstrual bleeding, for several cycles);
severe weakness, up to complete loss of working capacity;
symptoms of hypovitaminosis (pale, flabby skin, brittle nails and hair);
decreased immunity (in particular, stomatitis may occur);
dysbiosis, constipation;
tooth loss;
lowering blood pressure;
constant feeling of cold;
mental disorders (minor depression, asthenia, apathetic stupor, etc.).
DIAGNOSIS AND TREATMENT OF CACHEXIA
The general exhaustion of the body is easy to identify by the appearance of the patient and the study of anamnesis, however, the specifics of the disease require detailed clinical studies: laboratory tests of blood and urine, ultrasound of organs whose diseases could cause cachexia, electro- and echocardiography, in the case of psychogenic origin – psychiatric consultations.
Treatment of cachexia is aimed at ridding the patient of the underlying disease that caused exhaustion. Additionally, drugs that can increase appetite are used, intravenous glucose infusion is possible. Patients with cachexia are prescribed a high-calorie diet, having previously examined the patient and excluded contraindications to such nutrition.
