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Restless legs syndrome in patients with high serum ferritin and normal iron levels

R. Peraita-Adrados, L.G. Duque-Ramírez, A. Vela-Bueno [REV NEUROL 2011;53:385-389] PMID: 21948008 DOI: https://doi.org/10.33588/rn.5307.2011234

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Volumen 53 | Number 07 | Nº of views of the article 10.606 | Nº of PDF downloads 1.455 | Article publication date 01/10/2011

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ABSTRACT

AIM To document the association between restless legs syndrome (RLS) and high ferritin levels in five patients.

PATIENTS AND METHODS The five patients were male, mean age: 59 years (range: 36-73 years). The patients were referred for RLS (two of them blood donors), in two cases associated with obstructive sleep apnea. Patients underwent a video-PSG recording. Serum iron and serum ferritin were determined.

RESULTS All patients fulfilled the clinical criteria for RLS: leg paresthesias associated with an urge to move, motor restlessness, worsening of symptoms during the evening and night, and partial relief with activity, difficulty falling asleep, and presence of nocturnal awakenings due to RLS. Neurological examination, EEGs, EMGs and MRIs were normal. Video-PSGs recordings showed a disturbed and fragmented sleep with a reduction in total sleep time, low sleep efficiency, respiratory abnormalities with an apnea-hipopnea index > 10/h in two cases, and in all of them a periodic leg movements index > 5/h. The serum iron levels were within the normal range in all cases, whereas those in serum ferritin levels were high.

CONCLUSIONS To our knowledge the association of normal serum iron with high serum ferritin levels in patients diagnosed clinically and polygraphically as having RLS with periodic leg movements has not been described before. The notion of an involvement of a dopaminergic mechanism in the pathophysiology of RLS is supported by the decrease in the values of serum ferritin concentration observed in one patient during follow-up while being treated with dopaminergic agents. KeywordsHigh serum ferritin Normal iron Periodic leg movements Restless legs syndrome Videopolisomnography CategoriesSueño Trastornos del movimiento

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Original

Restless legs syndrome in patients with high serum ferritin and normal iron levels