Restless legs syndrome is a relevant comorbidity in patients with inflammatory bowel disease
- 138 Downloads
Background and aims
In patients with inflammatory bowel disease (IBD), restless legs syndrome (RLS) may occur as an extraintestinal disease manifestation. Iron deficiency (ID) or folate deficiency/vitamin B12 deficiency (FD/VB12D) has previously been described to cause RLS. Here, we determined the prevalence and severity of RLS in IBD patients and evaluated the effect of iron and/or folic acid/vitamin B12 supplementation.
Patients were screened for ID and RLS by a gastroenterologist. If RLS was suspected, a neurologist was consulted for definitive diagnosis and severity. Patients with RLS and ID, FD, or VB12D received supplementation and were followed-up at weeks 4 and 11 after starting supplementation.
A total of 353 IBD patients were included. Prevalence for RLS was 9.4% in Crohn’s disease (CD) and 8% in ulcerative colitis (UC). Prevalence for the subgroup of clinically relevant RLS (symptoms ≥ twice/week with at least moderate distress) was 7.1% (n = 16) for CD and 4.8% (n = 6) for UC. 38.7% of RLS patients presented with ID, FD, and/or VB12D. Most frequently ID was seen (25.8%; n = 8). Iron supplementation resulted in RLS improvement (p = 0.029) at week 4 in seven out of eight patients.
Although the overall prevalence of RLS in IBD did not differ to the general population, clinically relevant RLS was more frequent in IBD patients and, therefore, it is important for clinicians to be aware of RLS symptoms. Though for definite diagnosis and proper treatment of RLS, a neurologist must be consulted. Additionally, iron supplementation of IBD patients with ID can improve RLS symptoms.
ClinicalTrials.gov No. NCT03457571
KeywordsRestless legs syndrome Inflammatory bowel disease Iron deficiency Crohn’s disease Ulcerative colitis
Compliance with ethical standards
The study was approved (16 January 2014) by the ethics committee of the Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin (reference EA4/132/13).
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.Ferro JM, Oliveira SN, Correia L (2014) Chapter 40—Neurologic manifestations of inflammatory bowel diseases. In: Biller J, Ferro JM (eds) Handbook of clinical neurology, vol 120. Neurologic aspects of systemic disease part II. Elsevier, Amsterdam, pp 595–605. Available at: http://www.sciencedirect.com/science/article/pii/B9780702040870000401. Accessed 18 Feb 2016
- 5.Weinstock LB, Bosworth BP, Scherl EJ, Li E, Iroku U, Munsell MA, Mullen GE, Walters AS (2010) Crohn’s disease is associated with restless legs syndrome. Inflamm Bowel Dis 16:275–279 Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3864021/. Accessed 29 May 2015CrossRefPubMedGoogle Scholar
- 7.Allen RP, Picchietti DL, Garcia-Borreguero D, Ondo WG, Walters AS, Winkelman JW, Zucconi M, Ferri R, Trenkwalder C, Lee HB, International Restless Legs Syndrome Study Group (2014) Restless legs syndrome/Willis–Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria—history, rationale, description, and significance. Sleep Med 15:860–873CrossRefPubMedGoogle Scholar
- 11.Winkelmann J, Schormair B, Lichtner P, Ripke S, Xiong L, Jalilzadeh S, Fulda S, Pütz B, Eckstein G, Hauk S, Trenkwalder C, Zimprich A, Stiasny-Kolster K, Oertel W, Bachmann CG, Paulus W, Peglau I, Eisensehr I, Montplaisir J, Turecki G, Rouleau G, Gieger C, Illig T, Wichmann HE, Holsboer F, Müller-Myhsok B, Meitinger T (2007) Genome-wide association study of restless legs syndrome identifies common variants in three genomic regions. Nat Genet 39:1000–1006CrossRefPubMedGoogle Scholar
- 18.Silverberg MS, Satsangi J, Ahmad T, Arnott IDR, Bernstein CN, Brant SR, Caprilli R, Colombel JF, Gasche C, Geboes K, Jewell DP, Karban A, Loftus EV, Peña AS, Riddell RH, Sachar DB, Schreiber S, Steinhart AH, Targan SR, Vermeire S, Warren BF (2005) Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a working party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol 19(Suppl A):5A–36ACrossRefPubMedGoogle Scholar
- 33.Schindlbeck KA, Becker J, Berger F et al (2016) Impact of restless legs syndrome in patients with inflammatory bowel disease on sleep, fatigue, and quality of life. Int J Color Dis:1–6Google Scholar