Differential Diagnosis for Night Sweats
Night sweats can be indicative of a variety of conditions, ranging from benign to life-threatening. The following differential diagnosis categorizes potential causes into four groups based on their likelihood and potential impact on patient health.
Single Most Likely Diagnosis
- Hormonal Changes: Night sweats are commonly associated with hormonal fluctuations, particularly in women undergoing menopause or perimenopause. The decline in estrogen levels can lead to hot flashes and night sweats. Similarly, hormonal changes during pregnancy or thyroid disorders can also cause night sweats.
Other Likely Diagnoses
- Infections: Tuberculosis (TB) is a well-known cause of night sweats, often accompanied by other symptoms like fever, weight loss, and cough. Other infections such as endocarditis, osteomyelitis, or abscesses can also present with night sweats.
- Medications: Certain medications, including antidepressants, hormone replacement therapy, and steroids, can induce night sweats as a side effect.
- Sleep Disorders: Sleep apnea, insomnia, and restless leg syndrome can lead to night sweats due to increased stress and body temperature during sleep.
- Anxiety and Stress: High levels of anxiety and stress can cause hyperarousal, leading to increased body temperature and night sweats.
Do Not Miss Diagnoses
- Lymphoma: Night sweats can be a symptom of lymphoma, particularly Hodgkin's lymphoma. It is crucial to investigate further if other symptoms like weight loss, fever, or lymphadenopathy are present.
- Other Cancers: Certain cancers, such as leukemia or lung cancer, can cause night sweats, often in conjunction with other systemic symptoms.
- HIV Infection: Night sweats can be an early symptom of HIV infection, especially if accompanied by other signs like fever, weight loss, or lymphadenopathy.
Rare Diagnoses
- Pheochromocytoma: This rare tumor of the adrenal gland can cause episodic hypertension, sweating, and other symptoms, including night sweats.
- Neurological Disorders: Conditions like autonomic dysfunction or multiple system atrophy can lead to abnormal sweating patterns, including night sweats.
- Gastrointestinal Disorders: Certain gastrointestinal conditions, such as gastroesophageal reflux disease (GERD) or inflammatory bowel disease, can cause night sweats, although this is less common.