Symptom Persistence after Iron Normalization in Women with Restless Legs Syndrome
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective The aim of this study was to determine the clinical course of restless legs syndrome (RLS) and potential risk factors for the persistence of RLS symptoms after iron normalization in women with RLS and low serum ferritin (<50 μg/L). Methods We reviewed 39 women with RLS and iron deficiency, who achieved iron normalization after oral iron replacement for three months. Risk factors contributing to symptom persistence were estimated by logistic regression analyses. Remission was defined as no RLS symptoms for at least 6 months after the iron normalization. Results Over the observation period of 2.5±1.4 years, 15 patients reported no RLS symptom whereas 24 patients still complained of RLS symptoms. The remission rate of RLS with iron replacement was 38.5%. The relative risk of symptom persistence was increased by the duration of RLS symptoms (OR: 1.88, 95% CI: 1.01–3.49) or by the age at RLS diagnosis (OR: 1.25, 95% CI: 1.01–1.56). Conclusion Almost two-third of RLS patients with iron deficiency showed persistence of the symptom even after iron normalization. Considering that longer duration of RLS symptoms and older age at RLS diagnosis were risk factors for symptom persistence, early intervention of iron deficiency in RLS is warranted.
Abstract
Objective The aim of this study was to determine the clinical course of restless legs syndrome (RLS) and potential risk factors for the persistence of RLS symptoms after iron normalization in women with RLS and low serum ferritin (<50 μg/L). Methods We reviewed 39 women with RLS and iron deficiency, who achieved iron normalization after oral iron replacement for three months. Risk factors contributing to symptom persistence were estimated by logistic regression analyses. Remission was defined as no RLS symptoms for at least 6 months after the iron normalization. Results Over the observation period of 2.5±1.4 years, 15 patients reported no RLS symptom whereas 24 patients still complained of RLS symptoms. The remission rate of RLS with iron replacement was 38.5%. The relative risk of symptom persistence was increased by the duration of RLS symptoms (OR: 1.88, 95% CI: 1.01–3.49) or by the age at RLS diagnosis (OR: 1.25, 95% CI: 1.01–1.56). Conclusion Almost two-third of RLS patients with iron deficiency showed persistence of the symptom even after iron normalization. Considering that longer duration of RLS symptoms and older age at RLS diagnosis were risk factors for symptom persistence, early intervention of iron deficiency in RLS is warranted.
참고문헌 (27)
- Kushida CA, "Clinical presentation, diagnosis, and quality of life issues in restless legs syndrome", Am J Med, 120(1 Suppl 1), pp.S4~S12 (2007)
- Lee CS, "Symptom severity of restless legs syndrome predicts its clinical course", Am J Med, 129, pp.438~445 (2016)[DOI]
- Allen R, "Dopamine and iron in the pathophysiology of restless legs syndrome (RLS)", Sleep Med, 5, pp.385~391 (2004)[DOI]
- Silber MH, "An algorithm for the management of restless legs syndrome", Mayo Clinic Proc, 79, pp.916~922 (2004)[DOI]
- Thorpy MJ, "New paradigms in the treatment of restless legs syndrome", Neurology, 64(12 Suppl 3), pp.S28~S33 (2005)[DOI]
- Wang J, "Efficacy of oral iron in patients with restless legs syndrome and a low-normal ferritin: a randomized, double-blind, placebo-controlled study", Sleep Med, 10, pp.973~975 (2009)[DOI]
- Grote L, "A randomized, double-blind, placebo controlled, multi-center study of intravenous iron sucrose and placebo in the treatment of restless legs syndrome", Mov Disord, 24, pp.1445~1452 (2009)[DOI]
- Walters AS, "Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome", Sleep Med, 4, pp.121~132 (2003)[DOI]
- Lee CS, "Comparison of the efficacies of oral iron and pramipexole for the treatment of restless legs syndrome patients with low serum ferritin", Eur J Neurol, 21, pp.260~266 (2014)[DOI]
- Allen RP, "Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health", Sleep Med, 4, pp.101~119 (2003)[DOI]
- Allen RP, "Restless legs syndrome", Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance, 2014, pp.15, 860~873
- Buysse DJ, "The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research", Psychiatry Res, 28, pp.193~213 (1989)[DOI]
- Johns MW, "A new method for measuring daytime sleepiness: the Epworth sleepiness scale", Sleep, 14, pp.540~545 (1991)[DOI]
- Alvarez-Ossorio L, "Low ferritin levels indicate the need for iron supplementation: strategy to minimize iron-depletion in regular blood donors", Transfus Med, 10, pp.107~112 (2000)[DOI]
- Allen RP, "The role of iron in restless legs syndrome", Mov Disord, 22(Suppl 18), pp.S440~S448 (2007)[DOI]
- Earley CJ, "Abnormalities in CSF concentrations of ferritin and transferrin in restless legs syndrome", Neurology, 54, pp.1698~1700 (2000)[DOI]
- Connor JR, "Decreased transferrin receptor expression by neuromelanin cells in restless legs syndrome", Neurology, 62, pp.1563~1567 (2004)[DOI]
- Connor JR, "Profile of altered brain iron acquisition in restless legs syndrome", Brain, 134, pp.959~968 (2011)[DOI]
- Davis BJ, "A randomized, double-blind placebo-controlled trial of iron in restless legs syndrome", Eur Neurol, 43, pp.70~75 (2000)[DOI]
- Sloand JA, "A double-blind, placebo-controlled trial of intravenous iron dextran therapy in patients with ESRD and restless legs syndrome", Am J Kidney Dis, 43, pp.663~670 (2004)[DOI]
- Earley CJ, "A randomized, double-blind, placebo-controlled trial of intravenous iron sucrose in restless legs syndrome", Sleep Med, 10, pp.206~211 (2009)[DOI]
- Ru Y, "Iron deficiency and anemia are prevalent in women with multiple gestations", Am J Clin Nutr, 104, pp.1052~1060 (2016)[DOI]
- Allen RP, "Restless Leg Syndrome", Willis-Ekbom Disease Pathophysiology, 2015, pp.10, 207~214
- Milman N, "Serum ferritin in Danes: studies of iron status from infancy to old age, during blood donation and pregnancy", Int J Hematol, 63, pp.103~135 (1996)[DOI]
- Kim KW, "Prevalence, comorbidities and risk factors of restless legs syndrome in the Korean elderly population-results from the Korean Longitudinal Study on Health and Aging", J Sleep Res, 19, pp.87~92 (2010)[DOI]
- Nichols DA, "Restless legs syndrome symptoms in primary care: a prevalence study", Arch Intern Med, 163, pp.2323~2329 (2003)[DOI]
- Earley CJ, "Repeated IV doses of iron provides effective supplemental treatment of restless legs syndrome", Sleep Med, 6, pp.301~305 (2005)[DOI]