Ostojic P, Jovic T, Stojic B
Institute of Rheumatology, School of Medicine, University of Belgrade, Resavska 69, 11000, Belgrade, Serbia.
Z Rheumatol. 2013 Aug;72(6):590-3. doi: 10.1007/s00393-013-1145-6.
This study aims to assess the prevalence and possible causes of restless legs syndrome (RLS) in patients with systemic sclerosis (SSc). The prevalence of RLS was assessed in 27 patients with SSc and 60 healthy controls. We evaluated the impact of age, disease duration, disease form, antibodies, and metoclopramide on the development of RLS in SSc patients. In order to reveal peripheral neuropathy or iron deficiency as possible causes of the syndrome, patients with RLS underwent electromyoneurography (EMNG) and ferritin level testing. RLS was diagnosed in 40.7% of SSc patients (11 out of 27), compared to 4.9% of healthy controls (p< 0.001). Eight out of 18 patients (44.4%) with diffuse SSc and 3 out of 9 patients (33.3%) with limited SSc exhibited RLS (p = 0.28). Mean age and mean disease duration did not differ significantly between patients with or without RLS. RLS was observed in 47.1% of patients with anticentromere antibodies and 30% of patients with anti-topoisomerase I antibodies (p = 0.22). RLS was diagnosed more frequently (p = 0.02) in patients taking metoclopramide (75%) than in patients who were not being treated with this drug (26.3%). EMNG revealed sensitive polyneuropathy in four, and lumbosacral radiculopathy in two out of 11 patients with RLS. Two patients with SSc and RLS had low levels of ferritin. Three patients had normal EMNG findings and ferritin levels. In conclusion, RLS is a common disorder in patients with SSc. Possible causes include sensitive polyneuropathy, lumbosacral radiculopathy, and iron deficiency. A strong relationship was observed between RLS and metoclopramide, which is sometimes used to treat SSc-related gastrointestinal motility disturbances.
本研究旨在评估系统性硬化症（SSc）患者中不宁腿综合征（RLS）的患病率及可能病因。对27例SSc患者和60名健康对照者进行了RLS患病率评估。我们评估了年龄、病程、疾病类型、抗体及甲氧氯普胺对SSc患者发生RLS的影响。为揭示该综合征可能的病因——周围神经病变或缺铁，对RLS患者进行了肌电图神经图（EMNG）检查及铁蛋白水平检测。SSc患者中40.7%（27例中的11例）被诊断为RLS，而健康对照者中这一比例为4.9%（p<0.001）。18例弥漫性SSc患者中有8例（44.4%）及9例局限性SSc患者中有3例（33.3%）出现RLS（p = 0.28）。有或无RLS的患者之间平均年龄和平均病程无显著差异。抗着丝点抗体阳性患者中47.1%出现RLS，抗拓扑异构酶I抗体阳性患者中30%出现RLS（p = 0.22）。服用甲氧氯普胺的患者中RLS诊断率更高（p = 0.02）（75%），高于未使用该药治疗的患者（26.3%）。EMNG显示，11例RLS患者中有4例存在感觉性多发性神经病，2例存在腰骶神经根病。2例SSc合并RLS患者铁蛋白水平较低。3例患者EMNG结果和铁蛋白水平正常。总之，RLS在SSc患者中是一种常见病症。可能病因包括感觉性多发性神经病、腰骶神经根病及缺铁。观察到RLS与甲氧氯普胺之间存在密切关系，甲氧氯普胺有时用于治疗SSc相关的胃肠动力障碍。
