Acute-Onset Disabling Restless Legs Syndrome and Periodic Limb Movements in a Context of Mesenteric Ischemia: Successful Management With Intravenous Iron Supplementation.

Abstract

An 87-year-old woman with a history of multiple cardiovascular conditions, diabetes mellitus, and chronic renal failure developed insomnia and restless leg syndrome (RLS) with periodic limb movements during hospitalization for superior mesenteric artery ischaemia, which was successfully treated by mechanical embolectomy. She was found to be anaemic, with a haemoglobin at 10.5 g/dL (reference range: 11.8 15 g/dL) and serum ferritin at 13μg/L (reference range: 30 400μg/L). Given the severity of her symptoms and iron deficiency, we opted against oral iron supplementation, as its absorption is slower and less efficient. Instead, we administered intravenous iron sucrose as a first-line treatment, resulting in a corrected ferritin level of 90μg/L. Her RLS symptoms regressed within two days after intravenous iron supplementation. This case highlights the importance of considering RLS in patients presenting with insomnia, as effective treatments are available to improve patient outcomes.