B symptoms


The term B symptoms is understood to mean the presence of specific general symptoms that indicate a consuming disease. Consuming means that it is a very stressful disease for the body that robs it of a lot of energy and overstrains the metabolism in the long term. Count with it Fever> 38 ° C, Night sweats and unwanted weight loss to the B symptoms.

According to the “Ann Arbor Classification for Malignant Lymphoma”, the letter “B” indicates the presence of symptoms, while “A” stands for freedom from symptoms. Clinically, the term is now used not only for malignant, but also for infectious diseases.


The causes for the presence of B-symptoms can be both in a infectious disease as well as one malignant tumor justify. In this case, both large disease groups have in common that they are serious disease courses.
The pathogens or mutated cells intervene immensely in the metabolism of the person affected and use up almost all energy reserves. In the case of an infectious disease with B symptoms, the person's immune system runs at full speed. With an increased body temperature, the body tries to kill the pathogens. At the same time, this leads to increased sweating.
The night sweats cannot be explained by this defense process alone. One explanation is that at night the metabolism is normally reduced and the body goes into a recovery phase. With a consuming illness, recovery is not completely possible and neither metabolic processes nor body temperature can be regulated down.
Malignant tumors, on the other hand, manipulate the immune system and suppress the body's own defense against the harmful cells. Indeed, malignant tumors use the body's own supply structures and blood vessels to feed and enlarge themselves. The body must therefore do more than before and supply additional tissue. This in turn calls for a higher basal metabolic rate. Physically, the increased burning of calories is reflected in weight loss (for the B symptoms > 10% of body weight in the last 6 months). The increased body temperature and night sweats can partly be explained by this, but just as with infectious diseases, they have not yet been adequately investigated.


The diagnosis of an existing B-symptomatology is mainly made by the anamnese posed. In this examination step, the doctor specifically asks about the presence and duration of the symptoms. It is crucial that the severity of the symptoms already described is strong enough and, if possible, can also be objectified.
Therefore, the examining doctor will also after the initial consultation Measure temperature and body weight. In addition, there is often a blood sample (see also: Blood test) and a physical examination to get a possible first indication of changes.
The absolute honesty of the person concerned is essential in the context of such an investigation. Even small details can explain B symptoms or even defuse them and thus bring relief.

Concomitant symptoms

An existing B-symptomatology is often accompanied by other symptoms that go unnoticed. There are mostly mundane symptoms like fatigue and Reduction in performancewhich those affected often attribute to stress at work or difficulty sleeping. But also nausea or Loss of appetite can occur parallel to the B symptoms and can be wrongly justified with a nervous stomach or a gastrointestinal infection.
Psychological changes are rare, but they can also be an indication of a serious illness. So if a close caregiver shows a change in nature by being conspicuously aggressive or fearful, this can be a pioneering symptom. Not infrequently, however, this change in character can also be traced back to chronic pain, the cause of which is either still unexplained or which increases as the disease worsens.
It is tricky that it is really often symptoms that can normally be assigned to harmless infections or events. When first contacting the doctor, the right trigger is often not found and it is recommended to wait and see. Therefore, even almost insignificant symptoms should be observed critically and if they persist for longer than a few weeks, a further investigation should be initiated.


The B symptoms can only be with the Treatment of the underlying disease be successfully treated. The disease is the trigger and will cause the symptoms as long as they are present. Unfortunately, most of these are diseases that require a long therapy period. Therefore, if the B symptoms are severe, they are also treated right from the start. The aim is to positively influence the course of the disease and to reduce the subjective pressure of suffering. The actual success brings healing of the disease.
Medicines can only be used to treat B symptoms to a limited extent. Only the increased body temperature can be lowered with them. Rather, it is nursing measures like changing clothes regularly and taking appropriate personal care that can bring relief. In the case of severe weight loss, there is one Nutritional advice very useful. Care is taken to ensure that the calorie intake is appropriate to the condition of the disease and that sufficient nutrients are made available. Depending on the underlying disease, a balanced acid-base balance can also be aimed for in order to optimally support the therapy.


The duration of the B symptoms depends on the duration of the disease causing it. Conversely, this means that the B symptoms will be present for about as long as the disease itself. However, they decrease in the course of effective treatment and thus reflect the success of the therapy. Since there are many different diseases that trigger the B symptoms, it is not possible to specify the duration precisely and must be assessed individually.

B symptoms in tumor / cancer

A tumor can be associated with B symptoms, but does not have to be. Conversely, this means that B symptoms do not prove a malignant disease. In the case of a malignant tumor, which is colloquially referred to as cancer, the presence of B symptoms is often the first indication of the presence of a tumor.
Those affected have often blamed other unspecific symptoms, such as nausea or reduced performance, for other causes and only later notice that their general condition has visibly deteriorated or changed. Especially in malignant tumors that do not allow large masses to grow in the body or that grow very slowly overall, the development of B symptoms is often the first sign.
It is not infrequently the case that the symptom triad of the B symptoms “fever, night sweats, weight loss” undergoes a habitual effect over the mostly long period of time, so that those affected only correctly interpret their symptoms in retrospect. From a clinical point of view, the presence of B symptoms is prognostically unfavorable, but this may need to be corrected in individual cases. It can be seen as positive that the search for an unknown tumor has started and the therapy can be started as quickly as possible.

Read more on the subject at: tumor

For more information on weight loss in cancer, see the clinical picture of "Cachexia".

B symptoms in rheumatism

Rheumatism is one of the Autoimmune diseases and cannot be called a specific disease. Rather, it is a collective term for various diseases.
It is typical of these diseases that they are accompanied by inflammation and metabolic disorders. Exactly this combination can cause B symptoms in severe disease courses. In most cases, those affected go to the doctor beforehand, so that the B symptoms are then often counted as an attack or can be seen as the course of the rheumatism.
Nevertheless, new B symptoms should always be clarified, as the risk of lymphoma is increased if a rheumatic disease is present.

B symptoms in tuberculosis

The tuberculosis is one of the infectious diseases that caused by bacteria becomes. If the disease progresses more seriously, it can lead to fever and weight loss. If the symptoms are very pronounced, doctors then speak of the presence of B symptoms.
Since tuberculosis can manifest itself in very diverse ways, the designation B symptoms should be seen as a working hypothesis up to the precise diagnosis. Tuberculosis does not always only develop in the lungs can theoretically affect any organ. If the pathogens get into the intestine, this can result in a metabolic disorder. Weight loss over a long period of time could then be the result and reflect a further part of the symptom triad.

B symptoms in sarcoid

The Sarcoid is a systemic disease that in principle occurs throughout the body inflammatory changes in connective tissue can lead. If the sarcoid is not expressed in the lungs, as is 90% of the time, and makes the lung changes that are specific to this disease, it can definitely produce the clinical picture of B symptoms in the patient.
Precisely because it is chronic in most cases, it can lead to a permanent increase in body temperature and weight loss within various attacks of inflammation. However, the nodular changes in the connective tissue typical of sarcoid should confirm the diagnosis of this systemic disease through a precise anamnesis and physical examination.

B symptoms in lymphoma

For a more precise classification of the Lymphoma the Ann Arbor classification was developed. It differentiates malignant lymphomas according to their involvement pattern in stages and additionally with the letters "A" and "B" according to the presence of general symptoms. The aim of this classification is to determine the patient's prognosis and to optimally adapt his therapy to his or her stage of the disease.
At the beginning of their illness, patients with lymphoma often suffer from an increased susceptibility to infections, which is almost always accompanied by swelling of the lymph nodes. It is noticeable that the infections accumulate over time and are very stressful for the body. The patient then shows the presence of B symptoms, the typical of this disease is. The presence of the complete triad of symptoms consisting of “fever, night sweats and weight loss” indicates a lymphoma.