PreprintCommunicationVersion 1This version is not peer-reviewed
Progressive Cachexia: Tuberculosis, Cancer or Thyrotoxicosis? – Disease-Directed Therapy and Atypical Course of Autoimmune and Malignant Thyroid Disease in High Specialization Era. Case Control Study with Critical Literature Review
Version 1
: Received: 14 October 2024 / Approved: 14 October 2024 / Online: 14 October 2024 (21:21:49 CEST)
How to cite:
Zdziarski, P.; Wojnar, A. Progressive Cachexia: Tuberculosis, Cancer or Thyrotoxicosis? – Disease-Directed Therapy and Atypical Course of Autoimmune and Malignant Thyroid Disease in High Specialization Era. Case Control Study with Critical Literature Review. Preprints2024, 2024101090. https://doi.org/10.20944/preprints202410.1090.v1
Zdziarski, P.; Wojnar, A. Progressive Cachexia: Tuberculosis, Cancer or Thyrotoxicosis? – Disease-Directed Therapy and Atypical Course of Autoimmune and Malignant Thyroid Disease in High Specialization Era. Case Control Study with Critical Literature Review. Preprints 2024, 2024101090. https://doi.org/10.20944/preprints202410.1090.v1
Zdziarski, P.; Wojnar, A. Progressive Cachexia: Tuberculosis, Cancer or Thyrotoxicosis? – Disease-Directed Therapy and Atypical Course of Autoimmune and Malignant Thyroid Disease in High Specialization Era. Case Control Study with Critical Literature Review. Preprints2024, 2024101090. https://doi.org/10.20944/preprints202410.1090.v1
APA Style
Zdziarski, P., & Wojnar, A. (2024). Progressive Cachexia: Tuberculosis, Cancer or Thyrotoxicosis? – Disease-Directed Therapy and Atypical Course of Autoimmune and Malignant Thyroid Disease in High Specialization Era. Case Control Study with Critical Literature Review. Preprints. https://doi.org/10.20944/preprints202410.1090.v1
Chicago/Turabian Style
Zdziarski, P. and Andrzej Wojnar. 2024 "Progressive Cachexia: Tuberculosis, Cancer or Thyrotoxicosis? – Disease-Directed Therapy and Atypical Course of Autoimmune and Malignant Thyroid Disease in High Specialization Era. Case Control Study with Critical Literature Review" Preprints. https://doi.org/10.20944/preprints202410.1090.v1
Abstract
Critical and progressive cachexia may be observed in numerous medical disciplines, but in patients with various diseases several pathways overlap (endocrine, inflammatory and kidney diseases, heart failure, cancer). A case-control analysis is presented of patients with initial immune-mediated thyroiditis complicated with cachexia, pulmonary pa-thology coexisting with opportunistic infection, finally diagnosed cancer (thyroid cancer, misdiagnosed as NSCLC). Contrary to other patients with lung cancer the presented pa-tients were not active smokers, exclusively women who developed cachexia with existing autoimmune process in the first phase. Furthermore, coexistence of short overall survival without cancer progression in the most seriously ill patients, correlation with sex (con-trary to history of smoking) and predisposition to mycobacterial disease are very sug-gestive. The unique sequence shed light on immune-mediated thyroid disease as a sub-clinical paraneoplastic process modified by various therapeutic regimens, however, with systemic consequences and a sequel, requiring holistic approach. Differential diagnosis of severe cachexia, adenocarcinoma with pulmonary localization and tuberculosis reac-tivation require analysis of immunological and genetic background. Contrary to highly specialized teams (e.g. lung cancer units) the immunotherapy and general medicine in aging populations require multidisciplinary observation, holistic and inquiring approach.
Lack of differentiation, confusing bias as well as discrepancy in literature are the main obstacles in statistical research, that indicate correlation of common factors only. Such time-lapse case studies may be first to build evidence of a pathway and association be-tween immune parameters, comorbidity and cancer.
Keywords
Cachexia; Graves; de Quervain autoimmune thyroiditis; paraneoplastic syndrome; thyroid cancer; BRAF; mycobacterial disease; cachectin/TNF; statistical bias; patient-centered care; precision medicine
Subject
Medicine and Pharmacology, Oncology and Oncogenics
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
