Simone Lawson
Constitutional symptoms are a set of non-specific symptoms that indicate a generalized illness and are not representative of any specific organ system or syndrome. They include weight loss, fever, and fatigue. These symptoms are prevalent in many diseases and are especially worrying if the patient is immunocompromised. They are also common during periods of active disease. For example, children with acute watery diarrhea consumed only 47% to 58% of the calories consumed by the healthy control group.
| Characteristics | Values |
|---|---|
| Constitutional symptoms | Fever, chills, night sweats, malaise, anorexia, weight loss, alopecia, arthralgias, lymphadenopathy, hepatosplenomegaly, fatigue, and infection |
| Not constitutional symptoms | Fig-warts, constitutional states such as anemia, and acute miasm |
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What You'll Learn
Constitutional symptoms are non-specific
Constitutional symptoms are prevalent in many diseases, and by themselves, they are not specific enough to diagnose a particular disease. However, they can be indicative of an underlying issue. For example, in children with acute watery diarrhoea, constitutional symptoms like fever, anorexia, and weight loss are common. Similarly, fatigue is a common symptom in adolescents with SS, and lymphadenopathy, fever, and weight loss have also been reported in Japanese children with SS.
In the context of chronic lymphocytic leukaemia (CLL), constitutional symptoms like fever, night sweats, weight loss, infections, or anemia may be present. Additionally, patients with polycystic kidney disease may experience non-specific early signs such as fatigue, weakness, decreased cognitive functioning, irritability, and nausea.
It is important to note that constitutional symptoms can also be associated with psychological factors. For instance, patients with depression often experience more fatigue. Furthermore, depression may develop as a reaction to severe pain, stiffness, and malaise that limit physical activities.
While constitutional symptoms are non-specific, they can be crucial in identifying potential health issues and prompting further investigation and follow-up.
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They indicate a generalised illness
Constitutional symptoms refer to a set of non-specific symptoms that indicate a generalised illness and are not representative of any specific organ system or syndrome. They are common and can include profound fatigue, anorexia, weight loss, low-grade fever, chills, night sweats, malaise, alopecia, and arthralgias. These symptoms are a manifestation of fever, anorexia, malaise, headache, and myalgia.
Fever, for example, is the hallmark sign of infection, induced by the release of interleukin-1 (IL-1), IL-6, and tumour necrosis factor-α (TNF-α), which act on the hypothalamus to alter the temperature set point. This response comes at a substantial metabolic cost, with a 1°C increase in body temperature increasing the basal metabolic rate by 12-23%. Accompanying this, anorexia is a common symptom, though the reason for this is not clear.
Constitutional symptoms are especially concerning if the patient is immunocompromised, has diabetes, or has other risk factors for infection, such as a recent bacterial infection or injection drug use. They can also indicate malignancy, particularly in patients who do not respond to corticosteroids. For instance, chronic lymphocytic leukaemia (CLL), the most common B-cell malignancy in North America, can present with constitutional symptoms like fever, night sweats, weight loss, infections, or anaemia.
In children, constitutional symptoms such as fever, lymphadenopathy, and weight loss can be indicative of childhood SS. A study of Japanese children with SS reported easy fatigability in 30% of cases. These symptoms are prevalent in many diseases and are not specific to childhood SS, but if they persist without a clear cause, it should be considered in the differential diagnosis.
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They are not representative of a specific organ system or syndrome
Constitutional symptoms are a set of non-specific symptoms that indicate a generalised illness. They are not representative of a specific organ system or syndrome. These symptoms are common and include profound fatigue, anorexia, weight loss, low-grade fever, chills, night sweats, malaise, and unintended weight loss. They suggest infection or malignancy, and can be particularly worrying if the patient is immunocompromised, has diabetes, or has other risk factors for infection, such as a recent bacterial infection or history of drug use.
Fever, for example, is a hallmark sign of infection, induced by the release of interleukin-1 (IL-1), IL-6, and tumour necrosis factor-α (TNF-α), which act on the hypothalamus to alter the temperature set point. Fever is generally accompanied by anorexia, although the reason for this is not clear. Other symptoms, such as headache, can also be a sign of the body fighting off an infection.
Constitutional symptoms are also prevalent in many diseases and are not specific to any one syndrome. For example, in children with SS, fatigue is common, and lymphadenopathy, fever, and weight loss have also been reported. In adults, chronic lymphocytic leukaemia (CLL) can present with constitutional symptoms like fever, night sweats, weight loss, infections, or anaemia.
It is important to note that constitutional symptoms can be indicative of a serious illness, and patients presenting with these symptoms should be carefully evaluated to rule out any specific organ system involvement or underlying syndrome.
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They include fever, weight loss, and fatigue
Constitutional symptoms are a common manifestation of an active disease. They include profound fatigue, anorexia, weight loss, and low-grade fever. These symptoms are not always specific to a particular disease, but they can be indicative of an infection or malignancy, especially in immunocompromised patients.
Fatigue is a common symptom in many conditions, including Addison's disease, where it is accompanied by intraventricular conduction delays. It is also prevalent in adolescents with SS, with one study reporting a 30% incidence rate among Japanese children. Fatigue can also be a sign of depression, with patients experiencing more fatigue when they are depressed.
Weight loss is another constitutional symptom that can be indicative of a more serious underlying condition. In the case of the 68-year-old man mentioned in the Mayo Clinic Proceedings, weight loss of 5 kg in 3 weeks was one of the symptoms that led to the discovery of disseminated histoplasmosis, likely caused by low-dose methotrexate therapy. Weight loss greater than 10% of body weight is considered a concerning constitutional symptom that may warrant intravenous amphotericin B therapy.
Fever, also known as pyrexia, is often a hallmark sign of infection. It is induced by the release of interleukin-1 (IL-1), IL-6, and tumor necrosis factor-α (TNF-α), which act on the hypothalamus to raise the body's temperature set point. Fever is generally accompanied by anorexia, although the reason for this is not yet fully understood. In the case of children with acute watery diarrhea, for example, fever was reported in up to 23% of cases.
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They can suggest infection or malignancy
Constitutional symptoms refer to a set of non-specific symptoms that indicate a generalised illness and are not representative of any specific organ system or syndrome. They can suggest infection or malignancy.
Constitutional symptoms are common and include profound fatigue, anorexia, weight loss, and low-grade fever. Depression may develop, usually as a reaction to the severe pain, stiffness, and malaise that limit physical activities. It is important to exclude infection and malignancy, particularly in patients who do not respond to corticosteroids. Patients ultimately diagnosed with cSLE frequently recount nonspecific constitutional symptoms that include fever, fatigue, anorexia, weight loss, alopecia, and arthralgias.
Fever is the hallmark sign of infection. It is induced by the release of interleukin-1 (IL-1), IL-6, and tumour necrosis factor-α (TNF-α), which act at the level of the hypothalamus to alter the temperature set point. Fever is generally accompanied by anorexia, though the reason for this host response is not clear.
Constitutional symptoms, such as fever, chills, night sweats, malaise, or unintended weight loss, suggest infection or malignancy. They are especially worrisome if the patient is immunocompromised, including diabetes, or has other risk factors for infection, such as a recent bacterial infection or injection drug use. Back pain in an injection drug user is generally assumed to be a spinal infection until ruled out with imaging studies.
In addition to the above, other constitutional symptoms include chills, night sweats, headache, myalgia, and lymphadenopathy.
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Frequently asked questions
Constitutional symptoms refer to a set of non-specific symptoms that indicate a generalised illness and are not representative of any specific organ system or syndrome.
Examples of constitutional symptoms include weight loss, fever, and fatigue. Other symptoms include anorexia, chills, night sweats, malaise, headache, alopecia, and arthralgias.
Constitutional symptoms are indicative of a generalised illness and can suggest infection or malignancy. They are especially concerning if the patient is immunocompromised or has risk factors for infection.
While constitutional symptoms can be indicative of an underlying illness, it is possible for some illnesses or infections to be asymptomatic, meaning they do not display any signs or symptoms.
