### Date : 2024-06-20 08:22 ### Topic : Night Sweats #medicine #internalmedicine #oncology ---- **Night sweats** are episodes of excessive sweating during sleep. They can be caused by a variety of conditions, ranging from infections to hormonal imbalances and malignancies. > Here are some common causes of night sweats: ### Infectious Diseases 1. **Tuberculosis (TB):** A common cause of night sweats. 2. **HIV/AIDS:** Often associated with night sweats, especially during the acute and late stages of infection. 3. **Endocarditis:** Infection of the inner lining of the heart. 4. **Osteomyelitis:** Infection of the bones. 5. **Brucellosis:** A bacterial infection that spreads from animals to people, often causing night sweats. 6. **Malaria:** Night sweats can occur during fever cycles. ### Endocrine Disorders 1. **Hyperthyroidism:** Excess thyroid hormone production can cause increased metabolism and sweating. 2. **Diabetes Mellitus:** Particularly when blood sugar levels are low during the night (nocturnal hypoglycemia). 3. **Pheochromocytoma:** A rare tumor of the adrenal gland that can cause episodic sweating. ### Hormonal Changes 1. **Menopause:** Hot flashes and night sweats are common symptoms due to changing hormone levels. 2. **Andropause:** Similar to menopause but occurs in men due to decreasing testosterone levels. ### Cancers 1. **Lymphomas:** Both Hodgkin and non-Hodgkin lymphoma are associated with night sweats. 2. **Leukemia:** Can cause fever and night sweats. 3. **Other Malignancies:** Various cancers can cause systemic symptoms, including night sweats. ### Medications 1. **Antipyretics and Analgesics:** Medications like acetaminophen and aspirin can sometimes cause night sweats. 2. **Antidepressants:** Particularly selective serotonin reuptake inhibitors (SSRIs). 3. **Hormone Therapy:** Medications affecting hormone levels, such as those used in cancer treatments, can cause night sweats. ### Autoimmune Diseases 1. **Rheumatoid Arthritis:** Can cause systemic symptoms, including night sweats. 2. **Systemic Lupus Erythematosus (SLE):** An autoimmune disease with systemic manifestations. ### Neurological Conditions 1. **Autonomic Dysreflexia:** Common in people with spinal cord injuries above the T6 level. 2. **Stroke:** Can sometimes cause changes in the autonomic nervous system leading to sweating. ### Psychological Conditions 1. **Anxiety Disorders:** Can cause night sweats due to increased autonomic nervous system activity. 2. **Stress:** Chronic stress can lead to night sweats. ### Other Causes 1. **Obstructive Sleep Apnea (OSA):** Repeated episodes of blocked breathing during sleep can cause night sweats. 2. **Gastroesophageal Reflux Disease (GERD):** Can sometimes be associated with night sweats, particularly if acid reflux occurs during the night. ### Example Case Study **Patient Profile:** - **Name:** Jee Hoon Ju - **Age:** 45 - **Occupation:** Office Worker **Medical History:** - **Symptoms:** Night sweats for the past two months, accompanied by weight loss and fatigue. No significant past medical history, non-smoker. **Clinical Evaluation:** - **Physical Examination:** Low-grade fever, enlarged lymph nodes in the neck and armpits. **Laboratory Tests:** - **Complete Blood Count (CBC):** Reveals anemia and elevated white blood cell count. - **Chest X-ray:** Shows enlarged mediastinal lymph nodes. **Further Investigations:** - **CT Scan:** Confirms the presence of enlarged lymph nodes in the chest and abdomen. - **Biopsy:** Lymph node biopsy reveals Reed-Sternberg cells. **Diagnosis:** Based on the symptoms, clinical findings, and biopsy results, Jee Hoon Ju is diagnosed with Hodgkin lymphoma. ### Management 1. **Oncological Treatment:** - **Chemotherapy:** Standard regimen for Hodgkin lymphoma. - **Radiation Therapy:** Depending on the stage and spread of the disease. 2. **Symptomatic Treatment:** - **Antipyretics:** To manage fever. - **Hydration and Nutrition:** Supportive care to maintain strength and well-being. ### Conclusion Night sweats can be a symptom of various underlying conditions, ranging from infections and hormonal imbalances to malignancies and medication side effects. A thorough clinical evaluation and appropriate investigations are essential to determine the cause and guide effective treatment. In the example case, night sweats were a symptom of Hodgkin lymphoma, highlighting the importance of considering serious underlying conditions when evaluating this symptom.