Miyaue Kazuki, Isono Hiroki
Department of General Medicine, HITO Medical Center, Ehime, JPN.
Cureus. 2024 Mar 31;16(3):e57354. doi: 10.7759/cureus.57354. eCollection 2024 Mar.
This case report explores a rare presentation of restless legs syndrome (RLS) in a 59-year-old female with a history of Graves' disease (GD), highlighting the diagnostic challenges and the importance of considering thyroid dysfunctions in RLS. The patient, previously diagnosed and treated for GD, presented with acute nocturnal discomfort in her lower limbs, along with symptoms of fatigue, weight loss, and palpitations. Physical examinations and thyroid function tests indicated a recurrence of GD. Her RLS symptoms notably resolved following the treatment of GD with methimazole, pointing towards secondary RLS induced by GD. This case emphasizes the necessity of a comprehensive diagnostic approach in RLS, particularly in differentiating it from mimicking conditions including leg cramps, arthritis, peripheral neuropathy, and drug-induced akathisia, and identifying underlying etiologies like thyroid dysfunctions. The resolution of RLS symptoms after GD treatment underlines the potential link between thyroid dysfunctions, iron metabolism, and the dopaminergic system in RLS pathophysiology.
本病例报告探讨了一名59岁患有格雷夫斯病(GD)的女性出现的罕见不安腿综合征(RLS)表现,强调了诊断挑战以及在RLS中考虑甲状腺功能障碍的重要性。该患者曾被诊断出患有GD并接受过治疗,此次出现下肢急性夜间不适,伴有疲劳、体重减轻和心悸症状。体格检查和甲状腺功能测试表明GD复发。在用甲巯咪唑治疗GD后,她的RLS症状明显缓解,表明是由GD诱发的继发性RLS。本病例强调了对RLS采用全面诊断方法的必要性,特别是要将其与包括腿部痉挛、关节炎、周围神经病变和药物性静坐不能等类似病症区分开来,并识别出潜在病因如甲状腺功能障碍。GD治疗后RLS症状的缓解突显了甲状腺功能障碍、铁代谢和多巴胺能系统在RLS病理生理学中的潜在联系。