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Classification according to ICD-10
R64 Cachexia
E41 Alimentary marasmus
B22.2 Cachexia syndrome as a result of HIV disease
ICD-10 online (WHO version 2019)

Under cachexia ( give a wiki. Κακός kakos ' bad 'and ἕξις hexis , state') refers to a morbid, very severe emaciation. Cachexia is a multifactorial syndrome that occurs in various chronic diseases. Many patients with chronic diseases such as cancer (50% to 80% of cancer patients are affected by cachexia), AIDS or autoimmune diseases suffer from this additional disease . It is a highly complex and still poorly understood syndrome that leads to uncontrollable weight loss. Shrinking fat reserves and a breakdown of muscle tissue lead to weakening. Cachexia is considered to be one of the factors contributing to premature death.

In Germany, the Medical Service of the Health Insurance (MDK) defines cachexia as a body mass index of less than 18 kg / m². In the coding recommendation No. 16 issued by the group of social medicine experts, the MDK defines cachexia with a BMI below 18.5 kg / m².


Possible causes are:


In recent years, studies with experimental models of cancer-associated cachexia have contributed to an improved understanding of how inflammatory processes and associated changes in metabolism trigger cachexia. These studies showed that inflammatory factors, through direct or indirect mechanisms, both affect appetite and alter fat and muscle metabolism, which can lead to weight loss.

Patients lose weight and strength unintentionally due to decreased food intake and altered metabolism. Fat reserves and skeletal muscle mass are increasingly being depleted, which cannot be reversed with food supplements. Cachexia significantly affects the patient's quality of life and worsens the outcome of ongoing therapies.

In the context of infectious diseases, much less is known about cachexia. It is also unclear whether the same molecular mechanisms of cachexia in cancer are also present in chronic infections. Virus infections lead to a serious reorganization of the architecture of the adipose tissue combined with the activation of lipolysis , a molecular cascade of processes that the body uses to dissolve its fat deposits . However, none of the inflammatory mediators known to induce cachexia in cancer played a role in a mouse model of infection-associated cachexia.

In contrast to inanition (emaciation), in cachexia not only the storage fat deposits , but also the building fat and muscles are broken down. Symptoms are increasing weakness and lethargy . The bone marrow turns into gelatinous marrow , and other organs also suffer from atrophy and functional failures . The condition becomes life-threatening when the heart muscle is attacked. Cachexia thus soon leads to irreversible (irreversible) changes and ultimately to death (“terminal cachexia” = end stage).


Despite the enormous clinical need, the standards for diagnosis and care of cachectic patients remain inadequate and effective treatment options are still lacking. The therapy consists of a nutritional treatment (especially artificial nutrition ) and removal of the triggering cause, as far as this can be treated. Such therapy is not always necessary at the inevitable end of life. The decisive factor is the patient's will, whether the patient is hungry at all and whether symptoms can actually be alleviated with a forced intake of food.

See also


  • JM Bauer, R. Wirth, D. Volker, C. Sieber: Malnutrition, sarcopenia and cachexia around old age - from pathophysiology to therapy. In: German Medical Weekly. Volume 133, 2008, pp. 305-310.

Individual evidence

  1. Renate Wahrig-Burfeind: Foreign Words Dictionary (= Truig. Vol. 2). New edition, 6th, completely revised and updated edition. Wissen-Media-Verlag, Gütersloh et al. 2007, ISBN 978-3-577-09030-8 .
  2. a b c d e MAS Eva Schweng: How viral infections lead to cachexia. In: idw Informationsdienst Wissenschaft, CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences. May 20, 2019, accessed May 22, 2019 .
  3. Coding recommendations of the MDK 2012 (PDF; 1.0 MB).
  4. a b Hatoon Baazim et al .: CD8 + T cells induce cachexia during chronic viral infection. In: Nature Immunology. May 20, 2019, accessed on May 22, 2019 .
  5. C. Bausewein et al .: Guide to Palliative Care. Palliative Medicine and Hospice Care. Urban & Fischer, Munich 2010, pp. 58/59, ISBN 978-3-437-23312-8 .