Yes, some patients develop
RLS as a consequence of another condition.
This is secondary RLS.
Many pregnant women (up to 15%) are affected by RLS symptoms that
are typically most distressing and disruptive in the third trimester
of
pregnancy. Treatment is usually withheld as most individuals notice
a
complete reversal in symptoms following parturition. The association
has
been attributed to reduced serum folate or serum ferritin in pregnancy.
Rarely RLS occurs secondary to a pathological state. These include:
Iron deficiency anaemia
Diabetes mellitus
End stage renal disease (ESRD) (particularly patients receiving
haemodialysis or peritoneal dialysis
Vitamin B12 /Folate deficiency
Parkinson's disease
Peripheral neuropathy
Fibromyalgia
Rheumatoid arthritis
Spinocerebellar ataxia
Charcot-Marie-Tooth disease (type 2)
The three major, reversible causes of RLS are iron deficiency anaemia,
pregnancy and ESRD. These conditions are all associated with iron
insufficiency. Furthermore, serum levels of ferritin (the main storage
unit for
iron) have been found to inversely correlate with the severity of
RLS. In one
study the CSF (fluid surrounding the central nervous system) of patients
with RLS contained low CSF ferritin and or high transferrin (changes
expected with iron deficiency). An MRI study revealed a reduced
concentration of iron in specific brain areas (substantia nigra and
putamen)
of patients with RLS compared to controls and the degree of abnormality
related to the severity of symptoms. These findings suggest that iron
insufficiency may play an important role in the pathophysiology of
RLS.
Patients should be checked for low iron stores as correction of iron
levels
can reverse the symptoms of RLS.
