Malabsorption is uncommon in restless legs syndrome

Abstract

Celiac disease (CD), which is one of the most important malabsorptive diseases in adults, has been associated with several neurological disorders including peripheral neuropathy, cerebellar ataxia, myopathy, and attention deficit hyperactivity disorders. Recently, 2 independent studies 1,2 reported a high prevalence of restless legs syndrome (RLS) in CD patients (25%–31%). In the first study, 1 iron deficiency was present in 40% of CD patients with active RLS compared with 6% of patients without RLS, whereas in the second study, 2 no significant correlation was found between RLS and iron parameters. Other authors 3 reported 4 patients with RLS and serum ferritin below 25 ng/mL whose screening tests were positive for CD. Because these data suggest that CD is frequently associated with RLS and because CD could be an underlying correctable factor for some patients diagnosed with idiopathic RLS, we evaluated the absorptive status in 112 consecutive patients referred to our Sleep Disorders Center (68 women, 44 men; mean age, 59.6 years) with a diagnosis of idiopathic RLS. The diagnosis of RLS was made by face-to-face interview using International Restless Legs Syndrome Study Group (IRLSSG) criteria. 4 In our patients, mean RLS severity according to the IRLSSG rating scale 5 was 24.9 (range, 10–38). Using current criteria, 6 CD diagnosis was based on the presence of specific screening antibodies in serum (antitransglutaminase IgAtTG) and on the evidence of intestinal damage at duodenal biopsy. For investigating malabsorption in our RLS patients, the following typical symptoms and signs of CD 7 were considered: abdominal pain, anorexia, diarrhea, flatulence, muscle wasting, vomiting, and weight loss. Moreover, all patients were tested for anti-tTG antibodies with the Eu-tTG Quick test (refence 9113, lot 3368, Eurospital). 8