The term B-symptomatics refers to the presence of specific general symptoms that indicate a consuming disorder. Consuming means that it is a very stressful disease for the body, which robs it of a lot of energy and overstrains the metabolism in the long run. Thus fever > 38°C, night sweat and unintentional weight loss are among the B symptoms. According to the Ann-Arbor classification for malignant lymphomas, the letter “B” indicates the presence of symptoms, whereas “A” stands for freedom from symptoms. Clinically, the term is not only used today for malignant but also for infectious diseases.
The causes for the presence of B symptoms can be based on both an infectious disease and a malignant tumour. In this case, both large groups of diseases have in common that they are serious diseases. The pathogens or mutated cells intervene immensely in the metabolism of the affected person and consume almost all energy reserves.
In the case of an infectious disease with B-symptoms, the immune system of the affected person is running at full speed. With an increased body temperature, the body tries to kill the pathogens. At the same time this leads to increased sweating.
However, night sweats cannot be explained by this defence process alone. One explanation is that the metabolism is normally reduced at night and the body enters a recovery phase. In the case of a consuming disease, recovery is not completely possible and neither metabolic processes nor body temperature can be regulated down.
Malignant tumours, on the other hand, manipulate the immune system and suppress the body’s own defence against harmful cells. In fact, malignant tumors use the body’s own supply structures and blood vessels to feed and enlarge themselves. The body must therefore perform better than before and supply additional tissue.
This in turn requires a higher basal metabolic rate. Physically, the increased burning of calories results in weight loss (for B-symptoms > 10% of body weight in the last 6 months). The increased body temperature and night sweats are partly explainable by this, but just as with infectious diseases, they have not yet been sufficiently investigated.
An existing B symptomatology is often accompanied by other symptoms without being noticed. These are mainly banal symptoms such as fatigue and reduced performance, which those affected often attribute to stress at work or sleep disorders. However, nausea or loss of appetite can also occur parallel to the B-symptoms and can be falsely attributed to a nervous stomach or a gastrointestinal infection.
Although psychological changes are rare, they can also be an indication of a serious illness. If a close relative shows a change of character by being conspicuously aggressive or fearful, this can be a groundbreaking symptom. Often, however, this change of character is also due to chronic pain, the cause of which is either still unknown or which increases as the illness worsens.
It is treacherous that they are really often symptoms that can be attributed to normally harmless infections or events. At the initial contact with the doctor, the right trigger is often not yet found and waiting is recommended. Therefore even almost insignificant symptoms should be observed critically and if they persist for longer than a few weeks, further clarification should be initiated.