M.A.S
Forum Senior
Topics: 28
Posts: 56
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In diseases which have night sweats as a symptom (e.g. TB, infective endocarditis, etc.) what causes the sweats to occur only at night and not consistently during the day as well?
What is the commonest cause of night sweats?
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| gballarino
Forum Senior
Topics: 12
Posts: 96
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Hey... M.A.S. ... I´m still trying to recover from your last post! :lol:
About the physiopathology of night sweats... I´m just improvising here, but, the normal temperature is suposed to vary along the course of the day, with higher temperatures around 4-6 PM and lower temperatures around 4-6 AM. During a febrile illness, diurnal variations are usually maintained but at higher levels, so... I´m guessing that vasodilation and sweating at night is a mechanism to lower the exesive temperature. That, though, wouldn´t explain why only certain diseases produce night sweats, would it?
Second guess are alterations in cytokines balance. Not sure about the details though.
About the commonest causes... mmm, I´m tempted to say TB, which is really common down here. But Perhaps in the US the prevalence of TB is not that high. I´m thinking hematologic malignancies.
Please don´t keep me wondering.
___________________
Guillermo Ballarino
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| M.A.S
Forum Senior
Topics: 28
Posts: 56
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gballarino, I appreciate highly your reaction, and I'm wondered too, not only you.
Someone asked the authors of Kumar and Clark CLINICAL MEDICINE about that on their website, but unfortunately, their answer was shallow and not so convincing. They said:
"Sweats do mainly occur at night but patients often have a fever during the daytime but sweating is not prominent. Remember the commonest cause of night sweats is anxiety not an infective cause."
Do you think that anxiety is really the most common cause of night sweat?
Do you think that it may be sometimes a 'subjective symptom'?
The ideas you have introduced about body temperature variation and the role of cytokines (IL-1, IL-6, TNF, IFN alpha and others) as pyrogens may be the most likely. However, you haven't satisfied me.
Although that is not of so clinical significance, I hope anyone has "a clear idea" to introduce it.
Regards
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