{"id":10002,"date":"2023-04-12T20:13:00","date_gmt":"2023-04-12T20:13:00","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/?p=10002"},"modified":"2025-12-30T19:47:28","modified_gmt":"2025-12-30T19:47:28","slug":"rheumatoid-cachexia","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/rheumatoid-cachexia\/","title":{"rendered":"Diagnostic Criteria for Rheumatoid Cachexia"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Cachexia in RA (rheumatoid cachexia, RC), is mainly characterized by loss of muscle mass, in particular appendicular lean mass (ALM), and associated with accumulated fat mass (FM), situated mainly in the trunk area, indicating a shift towards the development of abdominal obesity. The loss of body cell mass (BCM) consists of an important issue of concern for patients with RA. BCM consists primarily of muscle and visceral mass (erythrocytes, serum proteins, lymphocytes, etc.), and is the part of the body with the greatest metabolic activity (95% of the total activity), determining protein requirements, energy expenditure, and the metabolic response to stress.<\/p>\n<p><!--more--><\/p>\n<p>Diagnostic criteria for RC differed greatly between studies, with several researchers adopting the Engvall criteria, some diagnosing RC using the Elkan criteria and others the M\u00fcller criteria for RC diagnosis.<\/p>\n<p><strong>Diagnostic Criteria for Rheumatoid Cachexia<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%; height: 166px;\" border=\"1\">\n<tbody>\n<tr style=\"height: 48px;\">\n<td style=\"width: 11.1111%; height: 48px;\"><strong><span style=\"font-size: 10pt;\">Diagnosis<\/span><\/strong><\/td>\n<td style=\"width: 6.21172%; height: 48px;\"><strong><span style=\"font-size: 10pt;\">Author<\/span><\/strong><\/td>\n<td style=\"width: 13.8232%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">BW loss\u2020<\/span><\/strong><\/td>\n<td style=\"width: 9.14256%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">FFMI (kg\/m2)<\/span><\/strong><\/td>\n<td style=\"width: 9.53629%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">FMI (kg\/m2)<\/span><\/strong><\/td>\n<td style=\"width: 11.3735%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">BF<\/span><\/strong><br \/>\n<strong><span style=\"font-size: 10pt;\">(% of BW)<\/span><\/strong><\/td>\n<td style=\"width: 10.7174%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">Low<\/span><\/strong><br \/>\n<strong><span style=\"font-size: 10pt;\">muscle<\/span><\/strong><br \/>\n<strong><span style=\"font-size: 10pt;\">strength<\/span><\/strong><\/td>\n<td style=\"width: 6.25545%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">Fatigue<\/span><\/strong><\/td>\n<td style=\"width: 10.0612%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">Anorexia<\/span><\/strong><\/td>\n<td style=\"width: 11.7673%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">Abnormal<\/span><\/strong><br \/>\n<strong><span style=\"font-size: 10pt;\">biochemistry<\/span><\/strong><\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 11.1111%; height: 108px;\" rowspan=\"3\"><span style=\"font-size: 10pt;\">Rheumatoid<\/span><br \/>\n<span style=\"font-size: 10pt;\">cachexia<\/span><\/td>\n<td style=\"width: 6.21172%; height: 24px;\"><span style=\"font-size: 10pt;\">Engvall <\/span><\/td>\n<td style=\"width: 13.8232%; height: 24px; text-align: center;\"><\/td>\n<td style=\"width: 9.14256%; height: 24px; text-align: center;\"><span style=\"font-size: 10pt;\">&lt;10 PC*<\/span><\/td>\n<td style=\"width: 9.53629%; height: 24px; text-align: center;\"><span style=\"font-size: 10pt;\">&gt;25th PC*<\/span><\/td>\n<td style=\"width: 11.3735%; height: 24px; text-align: center;\"><\/td>\n<td style=\"width: 10.7174%; height: 24px; text-align: center;\"><\/td>\n<td style=\"width: 6.25545%; height: 24px; text-align: center;\"><\/td>\n<td style=\"width: 10.0612%; height: 24px; text-align: center;\"><\/td>\n<td style=\"width: 11.7673%; height: 24px; text-align: center;\"><\/td>\n<\/tr>\n<tr style=\"height: 27px;\">\n<td style=\"width: 6.21172%; height: 27px;\"><span style=\"font-size: 10pt;\">Elkan <\/span><\/td>\n<td style=\"width: 13.8232%; height: 27px; text-align: center;\"><\/td>\n<td style=\"width: 9.14256%; height: 27px; text-align: center;\"><span style=\"font-size: 10pt;\">&lt;25 PC*<\/span><\/td>\n<td style=\"width: 9.53629%; height: 27px; text-align: center;\"><span style=\"font-size: 10pt;\">&gt;50th PC*<\/span><\/td>\n<td style=\"width: 11.3735%; height: 27px; text-align: center;\"><\/td>\n<td style=\"width: 10.7174%; height: 27px; text-align: center;\"><\/td>\n<td style=\"width: 6.25545%; height: 27px; text-align: center;\"><\/td>\n<td style=\"width: 10.0612%; height: 27px; text-align: center;\"><\/td>\n<td style=\"width: 11.7673%; height: 27px; text-align: center;\"><\/td>\n<\/tr>\n<tr style=\"height: 96px;\">\n<td style=\"width: 6.21172%; height: 57px;\"><span style=\"font-size: 10pt;\">M\u00fcller<\/span><\/td>\n<td style=\"width: 13.8232%; height: 57px; text-align: center;\"><\/td>\n<td style=\"width: 9.14256%; height: 57px; text-align: center;\"><span style=\"font-size: 10pt;\">ALM\/height2<\/span><br \/>\n<span style=\"font-size: 10pt;\">&lt;20th PC*<\/span><\/td>\n<td style=\"width: 9.53629%; height: 57px; text-align: center;\"><\/td>\n<td style=\"width: 11.3735%; height: 57px; text-align: center;\"><span style=\"font-size: 10pt;\">&gt;25% for<\/span><br \/>\n<span style=\"font-size: 10pt;\">men,<\/span><br \/>\n<span style=\"font-size: 10pt;\">&gt;35% for<\/span><br \/>\n<span style=\"font-size: 10pt;\">women<\/span><\/td>\n<td style=\"width: 10.7174%; height: 57px; text-align: center;\"><\/td>\n<td style=\"width: 6.25545%; height: 57px; text-align: center;\"><\/td>\n<td style=\"width: 10.0612%; height: 57px; text-align: center;\"><\/td>\n<td style=\"width: 11.7673%; height: 57px; text-align: center;\"><\/td>\n<\/tr>\n<tr style=\"height: 480px;\">\n<td style=\"width: 11.1111%; height: 10px;\"><span style=\"font-size: 10pt;\">Cachexia<\/span><\/td>\n<td style=\"width: 6.21172%; height: 10px;\"><span style=\"font-size: 10pt;\">Evans<\/span><\/td>\n<td style=\"width: 13.8232%; height: 10px; text-align: center;\"><span style=\"font-size: 10pt;\">\u22655% in the previous<\/span><br \/>\n<span style=\"font-size: 10pt;\">12 months,<\/span><br \/>\n<span style=\"font-size: 10pt;\">or less in the<\/span><br \/>\n<span style=\"font-size: 10pt;\">presence of illness,<\/span><br \/>\n<span style=\"font-size: 10pt;\">or BMI &lt;20 kg\/m2,<\/span><br \/>\n<span style=\"font-size: 10pt;\">plus 3\/5 of the other<\/span><br \/>\n<span style=\"font-size: 10pt;\">criteria (on<\/span><br \/>\n<span style=\"font-size: 10pt;\">the right columns)<\/span><\/td>\n<td style=\"width: 9.14256%; height: 10px; text-align: center;\"><span style=\"font-size: 10pt;\">&lt;10th PC*,<\/span><br \/>\n<span style=\"font-size: 10pt;\">or ASMI (by<\/span><br \/>\n<span style=\"font-size: 10pt;\">DXA) &lt;7.25<\/span><br \/>\n<span style=\"font-size: 10pt;\">in men and<\/span><br \/>\n<span style=\"font-size: 10pt;\">&lt;5.45 in<\/span><br \/>\n<span style=\"font-size: 10pt;\">women<\/span><\/td>\n<td style=\"width: 9.53629%; height: 10px; text-align: center;\"><\/td>\n<td style=\"width: 11.3735%; height: 10px; text-align: center;\"><\/td>\n<td style=\"width: 10.7174%; height: 10px; text-align: center;\"><span style=\"font-size: 10pt;\">+<\/span><br \/>\n<span style=\"font-size: 10pt;\">(assessed<\/span><br \/>\n<span style=\"font-size: 10pt;\">via<\/span><br \/>\n<span style=\"font-size: 10pt;\">handgrip<\/span><br \/>\n<span style=\"font-size: 10pt;\">strength)<\/span><\/td>\n<td style=\"width: 6.25545%; height: 10px; text-align: center;\"><span style=\"font-size: 10pt;\">+<\/span><\/td>\n<td style=\"width: 10.0612%; height: 10px; text-align: center;\"><span style=\"font-size: 10pt;\">+<\/span><br \/>\n<span style=\"font-size: 10pt;\">Limited food <\/span><span style=\"font-size: 10pt;\">intake (i.e. EI&lt;20 <\/span><span style=\"font-size: 10pt;\">kcal\/kg of BW\/<\/span><span style=\"font-size: 10pt;\">day, or &lt;70% of <\/span><span style=\"font-size: 10pt;\">usual food intake), <\/span><span style=\"font-size: 10pt;\">or poor appetite<\/span><\/td>\n<td style=\"width: 11.7673%; height: 10px; text-align: center;\"><span style=\"font-size: 10pt;\">\u00b0 Elevated inflammatory<\/span><br \/>\n<span style=\"font-size: 10pt;\">markers (CRP&gt;5.0 <\/span><span style=\"font-size: 10pt;\">mg\/L, or <\/span><span style=\"font-size: 10pt;\">IL-6 &gt;4.0 pg\/mL)<\/span><br \/>\n<span style=\"font-size: 10pt;\">\u00b0 Anaemia <\/span><span style=\"font-size: 10pt;\">(Hb &lt;12 g\/dL)<\/span><br \/>\n<span style=\"font-size: 10pt;\">\u00b0 Serum albumin &lt;3.2 g\/<\/span><span style=\"font-size: 10pt;\">dL<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>ALM: appendicular lean mass (the sum of the lean tissue in the arms and legs: calculated by DXA); ASMI: appendicle skeletal muscle index; BMI: body mass index; BF: body fat; BW: body weight; CRP: c-reactive protein; DXA: dual-energy x-ray absorptiometry; EI: energy intake; Hb: haemoglobin; FMI: fat mass index; FFMI: fat-free mass index; IL-6: interleukin 6; PC: percentile; * of the sex-, age-, and ethnic-specific values; \u2020: oedema free.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Efthymiou E, Grammatikopoulou MG, Gkiouras K, Efthymiou G, Zafiriou E, Goulis DG, Sakkas LI, Bogdanos DP. Time to Deal with Rheumatoid Cachexia: Prevalence, Diagnostic Criteria, Treatment Effects and Evidence for Management. Mediterr J Rheumatol. 2022 Sep 30;33(3):271-290. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/36531417\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Hurtado-Torres GF, Gonz\u00e1lez-Baranda LL, Abud-Mendoza C. Rheumatoid cachexia and other nutritional alterations in rheumatologic diseases. Reumatol Clin. 2015 Sep-Oct;11(5):316-21. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26094123\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Mar 13, 2023.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[45],"tags":[2562,2561,16,15,14,13,1291,1289],"class_list":["post-10002","post","type-post","status-publish","format-standard","hentry","category-rheumatology","tag-cachexia","tag-caquexia","tag-criteria","tag-criterios","tag-diagnostic","tag-diagnostico","tag-reumatoide","tag-rheumatoid"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/10002","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=10002"}],"version-history":[{"count":17,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/10002\/revisions"}],"predecessor-version":[{"id":10042,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/10002\/revisions\/10042"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=10002"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=10002"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=10002"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}