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Setup of Capillary Electrophoresis-Inductively Coupled Plasma Mass Spectrometry (CE-ICP-MS) for Quantification of Iron Redox Species (Fe(II), Fe(III))
Published on: May 4, 2020
Iron's role in paediatric restless legs syndrome - a review
Cara Dosman1, Manisha Witmans, Lonnie Zwaigenbaum
1Department of Pediatrics, University of Alberta, Edmonton, Alberta.
Insights
Pediatric restless legs syndrome (RLS) treatment is crucial for child development. Oral iron may help RLS in children with low ferritin, but more research is needed.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Developmental Pediatrics
Background:
- Restless Legs Syndrome (RLS) in children causes sleep disturbances, impacting development and family well-being.
- RLS is linked to iron deficiency and dopaminergic system issues.
- Diagnostic criteria for pediatric RLS are evolving and challenging, particularly in preschoolers.
Purpose of the Study:
- To highlight the importance of RLS treatment in children.
- To discuss diagnostic challenges and current management strategies for pediatric RLS.
- To inform community physicians about RLS recognition and referral.
Main Methods:
- Review of current understanding of pediatric RLS pathophysiology.
- Analysis of diagnostic criteria and their limitations.
- Evaluation of treatment recommendations, including iron supplementation and behavioral strategies.
Main Results:
- Pediatric RLS treatment is vital due to associated developmental and behavioral issues.
- Oral iron therapy (3-6 mg/kg/day for 3 months) is suggested for ferritin <50 ug/L, despite limited evidence.
- Sleep hygiene and behavioral interventions are recommended adjuncts.
Conclusions:
- Early recognition and referral of pediatric RLS by community physicians are essential.
- While iron therapy shows promise, its efficacy requires further research.
- Safe iron supplementation necessitates monitoring of iron metabolism parameters.
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.
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