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Q What is the utility of Night sweats as a solitary symptom?

Evidence base: Single Literature Review. 1

  • All English, >18yo. >1966. NOT including Oestrogen/Androgen deficiencies. Mostly interested in GP.
  • University of Oklahoma Health Sciences Center.
  • Problems with standard definition. Poor recording of how info was proffered nor attempts to objectively quantify any symptoms.
  • Many descriptions and associations in literature but based on very small numbers.

Findings

  1. It is very common.
    • approx 10% of population but related to
      • how often awake to notice -> anxiety and pain.
      • hormonal status -> hot flushes
      • how the person is asked. ( appears to be normal )
  2. Little evidence it is a true association with the vast majority of diseases it is described as being so in the textbooks ^^
    • It has only really been investigated with a range of haematological malignancies.
    • Little literature on other malignancies or other infections really.
  3. It does not appear to be concerning.
    • at least not in elderly in population based follow up studies:
      1. n=842 GP, >65yo. 24% died over 8ys of FU but night sweats not predictive of death but did last for > 1y in those who survived. 2
      2. n=682 Geri clinic, 7ys FU but not predictive of death. 2
    • in HD/NHL often quoted as a B symptom but when separated from the other B symptoms = weight loss and fever, then the prognostic value disappears. 3

^^ "Clinical wisdom suggesting that TB causes night sweats appears to be valid in younger adults, those with extrapulmonary disease, and those with HIV/AIDS. However the 2 studies that attempted to develop clinical prediction rules for TB, and included night sweats in the initial predictor, did not include (it) in their final prediction model. The combination of HIV/AIDS and Mycobacterium avium complex appears most clearly to be associated with night sweats." The link between malignancies such as lymphoma and night sweats is less clear, and there is too little information on which to base decisions about other medical conditions."

  1. Mold JW, Holtzclaw BJ, McCarthy L. Night sweats: a systematic review of the literature. J Am Board Fam Med. 2012;25(6):878-893. doi:10.3122/jabfm.2012.06.120033 ↩

  2. Mold JW, Lawler F. The prognostic implications of night sweats in two cohorts of older patients. J Am Board Fam Med 2010;23:97–103. ↩↩

  3. Gobbi PG, Cavalli C, Gendarini A, Crema A, Ricevuti G, Federico M, Di Prisco U, Ascari E. Reevaluation of prognostic significance of symptoms in Hodgkin’s disease. Cancer 1985;56:2874 – 80. ↩