*4.1. General Manifestations*

More than half of pSS patients report disabling fatigue and non-restful sleep [202], partly related to poor sleep quality due to dryness, night pain and an increased prevalence of obstructive sleep apnoea [203]. Low-grade fever is found in 6% to 41% of pSS patients [204], while periodic fever is found more anecdotally [204]. Weight loss and night sweats may also be due to the systemic activity of the disease, autonomic involvement or lymphoma development. B symptoms—the triad of fever, night sweating and weight loss classically described in lymphomas—are found only in 15% of low-grade lymphomas associated with pSS [205].
