A patient with chronic obstructive disease (COPD) who develops pulmonary cachexia has a worse prognosis than a person who does not. The cachexia may develop for a number of reasons.


Risk factors for the pulmonary cachexia syndrome:

(1) anorexia with poor nutrition

(2) depression

(3) cytokine release associated with chronic inflammation or frequent acute exacerbations

(4) deconditioning

(5) chronic corticosteroid therapy

(6) medications with adverse nutritional effects (diarrhea, vomiting, etc)

(7) metabolic consequences of hypoxemia and/or hypercapnia

(8) comorbid conditions including alcohol abuse


Differential diagnosis:

(1) cancer-related cachexia

(2) malabsorption or chronic bowel disease


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