Iron's role in paediatric restless legs syndrome - a review.

Abstract:

:Paediatric restless legs syndrome (RLS) treatment is important because RLS's associated sleep disturbance causes significant developmental-behavioural morbidity and impacts family well-being. RLS is associated with brain iron insufficiency and dopaminergic dysfunction. Diagnosis requires fulfillment of diagnostic criteria, which for children are currently in evolution, and have limitations, especially in preschoolers. The community physician needs to recognize the possibility of RLS to refer to a sleep specialist for diagnostic confirmation and management recommendations, which include oral iron therapy, even though there is currently no definitive research evidence for iron efficacy in most children with RLS. A 3 mg to 6 mg elemental iron/kg/day dose for three months could be tried if the ferritin level is <50 ug/L. Sleep hygiene and behavioural strategies are also recommended. Iron supplementation should be safe in the absence of iron metabolism disorders, provided that transferrin saturation and ferritin levels are monitored pre-and post-treatment. :Il est important de traiter le syndrome des jambes sans repos en pédiatrie (SJSR) parce que les troubles du sommeil qui s’y associent entraînent une morbidité comportementale et développementale marquée et nuisent au bien-être familial. Le SJSR est lié à une carence en fer dans le cerveau et à une dysfonction dopaminergique. Pour poser le diagnostic, il faut respecter les critères diagnostiques qui, chez les enfants, sont actuellement en évolution et comportent des limites, notamment chez ceux d’âge préscolaire. Le médecin communautaire doit convenir de la possibilité de SJSR afin d’aiguiller l’enfant vers un spécialiste du sommeil qui confirmera le diagnostic et fera des recommandations de prise en charge. Ces recommandations incluent un traitement martial par voie orale, même s’il n’existe pas de recherche irréfutable démontrant l’efficacité du fer chez la plupart des enfants ayant un SJSR. On peut expérimenter une dose de fer élémentaire de 3 mg/kg/jour à 6 mg/kg/jour pendant trois mois si le taux de ferritine est inférieur à 50 ug/L. Des stratégies reliées à l’hygiène du sommeil et au comportement sont également recommandées. Les suppléments de fer ne devraient pas poser de danger en l’absence de troubles du métabolisme du fer, pourvu qu’une surveillance de la saturation en transferrine et du taux de ferritine soit assurée depuis le diagnostic jusqu’après le traitement.

journal_name

Paediatr Child Health

authors

Dosman C,Witmans M,Zwaigenbaum L

doi

10.1093/pch/17.4.193

subject

Has Abstract

pub_date

2012-04-01 00:00:00

pages

193-7

issue

4

eissn

1205-7088

issn

1918-1485

journal_volume

17

pub_type

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