Restless legs syndrome in patients with hereditary hemochromatosis

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Iron deficiency is important in the pathogenesis of restless legs syndrome (RLS), and iron supplementation improves its symptoms.1,2 Hereditary hemochromatosis (HH) is an autosomal recessive condition caused by mutations of the HFE gene in which excessive intestinal iron absorption leads to iron deposition in multiple organs.3 Iron therapy for RLS precipitated symptoms of iron overload in one patient with previously unrecognized HH,4 suggesting that monitoring of iron indexes may be required during iron therapy in RLS. We investigated the frequency of RLS and the relationship between RLS and iron indexes in consecutive adult patients with HH attending a large teaching hospital for therapeutic phlebotomy over a 3-month period. All 61 HH patients seen agreed to participate; 48 (79%) were men, and the median (range) age was 53 (24 to 82) years. The median (range) duration of phlebotomy was 12 (2 to 108) months, and 35 (62%) had serum ferritin level of <50 ng/mL. …