Night Sweats

 

There are many causes of night sweats other than lymphoma

In the absence of any blood or examination findings to suggest lymphoma, whole body imaging is NOT indicated.

Without abnormal blood count or examination findings the likelihood of lymphoma or leukaemia as a cause is extremely low and other causes should be sought.

 

Causes:

• Anxiety disorders
  
  
• Medications
  • Antidepressants especially SSRI
  • Hormone blocking drugs
  • Alcohol (use and withdrawal)
  • Recreational drugs (opioids, cocaine, cannabis, benzodiazepines)          
• Endocrine
  • Menopause and sex hormone deficiencies
  • Hypoglycaemia
  • Thyroid disease
  • Carcinoid
  • Phaechromocytoma

• Infection including HIV, TB and bacterial endocarditis
   
• Neurological       -
  • Stroke
  • Autonomic neuropathy

Investigation:

Thorough history especially of therapeutic or recreational drug use

FBC and blood film, electrolytes, liver function, bone screen

Consider LDH, immunoglobulins, HIV test

Sex hormones FSH, LH as indicated

Consider CXR

 

Who to refer?

• If there are any indicators of haematological malignancy on the above screening tests
• Involuntary weightloss
• Lymphadenopathy (as 2ww)
• Splenomegaly (as 2ww)

Do not refer isolated night sweats to haematology

 

Contributors:

Dr Richard Noble, Consultant Haematologist, RCHT

Dr Bridgitte Wesson, GP & Kernow RMS Haematology guideline lead

 

Review date: 13/07/2020

Next Review date: 13/07/2021