Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 6/2010

01-06-2010 | Original Article

Celiac Disease Is Associated with Restless Legs Syndrome

Authors: Leonard B. Weinstock, Arthur S. Walters, Gerard E. Mullin, Stephen P. Duntley

Published in: Digestive Diseases and Sciences | Issue 6/2010

Login to get access

Abstract

Purpose

Celiac disease may be associated with restless legs syndrome (RLS) because of an association with iron deficiency. Often, RLS negatively affects quality of life but may remain undiagnosed. This study evaluated the association between celiac disease and RLS.

Results

The incidence of RLS among 85 patients with celiac disease was 35%, with a prevalence of 25% compared with 10% of spouses (P < 0.02). In 79% of patients with RLS and celiac disease, neuromuscular symptoms began during or after onset of gastrointestinal symptoms. Iron deficiency was present in 40% of celiac patients with active RLS compared with 6% of patients without RLS (P < 0.001). After 6 months of a gluten-free diet, RLS symptoms improved in 50% of 28 patients.

Conclusion

Screening for celiac disease in patients with RLS is important since this commonly overlooked silent disease may be a correctable factor for some patients with idiopathic RLS.
Literature
1.
Green PH. The many faces of celiac disease: clinical presentation of celiac disease in the adult population. Gastroenterology. 2005;128:S74–S78.CrossRefPubMed
2.
Cranney A, Zarkadas M, Graham ID, et al. The Canadian celiac health survey. Dig Dis Sci. 2007;52:1087–1095.CrossRefPubMed
3.
Saalman R, Fallstrom SP. High incidence of urinary tract infection in patients with coeliac disease. Arch Dis Child. 1996;74:170–171.CrossRefPubMed
4.
Rampertab SD, Pooran N, Brar P, Singh P, Green PH. Trends in the presentation of celiac disease. Am J Med. 2006;119(355):e9–e14.PubMed
5.
Briani C, Zara G, Toffanin E, et al. Neurological complications of celiac disease and autoimmune mechanisms: preliminary data of a prospective study in adult patients. Ann N Y Acad Sci. 2005;1051:148–155.CrossRefPubMed
6.
Gabrielli M, Cremonini F, Fiore G, et al. Association between migraine and celiac disease: results from a preliminary case-control and therapeutic study. Am J Gastroenterol. 2003;98:625–629.CrossRefPubMed
7.
Gobbi G, Bouquet F, Greco L, et al. Coeliac disease, epilepsy, and cerebral calcifications. The Italian working group on coeliac Disease and epilepsy. Lancet. 1992;340:439–443.
8.
Green PH, Alaedini A, Sander HW, Brannagan TH 3rd, Latov N, Chin RL. Mechanisms underlying celiac disease and its neurologic manifestations. Cell Mol Life Sci. 2005;62:791–799.CrossRefPubMed
9.
Hadjivassiliou M, Chattopadhyay AK, Grunewald RA, et al. Myopathy associated with gluten sensitivity. Muscle Nerve. 2007;35:443–450.CrossRefPubMed
10.
Tursi A, Giorgetti GM, Iani C, et al. Peripheral neurological disturbances, autonomic dysfunction, and antineuronal antibodies in adult celiac disease before and after a gluten-free diet. Dig Dis Sci. 2006;51:1869–1874.CrossRefPubMed
11.
Zelnik N, Pacht A, Obeid R, Lerner A. Range of neurologic disorders in patients with celiac disease. Pediatrics. 2004;113:1672–1676.CrossRefPubMed
12.
Walters AS. Toward a better definition of the restless legs syndrome. The international restless legs syndrome study group. Mov Disord. 1995;10:634–642.
13.
Allen RP, Walters AS, Montplaisir J, et al. Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med. 2005;165:1286–1292.CrossRefPubMed
14.
Annibale B, Severi C, Chistolini A, et al. Efficacy of gluten-free diet alone on recovery from iron deficiency anemia in adult celiac patients. Am J Gastroenterol. 2001;96:132–137.CrossRefPubMed
15.
Harper JW, Holleran SF, Ramakrishnan R, Bhagat G, Green PH. Anemia in celiac disease is multifactorial in etiology. Am J Hematol. 2007;82:996–1000.CrossRefPubMed
16.
Allen RP, Earley CJ. The role of iron in restless legs syndrome. Mov Disord. 2007;22(Suppl 18):S440–S448.CrossRefPubMed
17.
Aul EA, Davis BJ, Rodnitzky RL. The importance of formal serum iron studies in the assessment of restless legs syndrome. Neurology. 1998;51:912.PubMed
18.
Sun ER, Chen CA, Ho G, Earley CJ, Allen RP. Iron and the restless legs syndrome. Sleep. 1998;21:371–377.PubMed
19.
Walters AS, LeBrocq C, Dhar A, et al. For the international restless legs syndrome study group. Validation of the international restless legs syndrome study group rating scale for restless legs syndrome. Sleep Med. 2003;4:121–132.
20.
Satija P, Ondo WG. Restless legs syndrome: pathophysiology, diagnosis and treatment. CNS Drugs. 2008;22:497–518.CrossRefPubMed
21.
Lee SK, Green PH. Celiac sprue (the great modern-day imposter). Curr Opin Rheumatol. 2006;18:101–107.CrossRefPubMed
22.
Berger K, von Eckardstein A, Trenkwalder C, Rothdach A, Junker R, Weiland SK. Iron metabolism and the risk of restless legs syndrome in an elderly general population–the MEMO-Study. J Neurol. 2002;249:1195–1199.CrossRefPubMed
23.
Oertel WH, Trenkwalder C, Zucconi M, et al. State of the art in restless legs syndrome therapy: practice recommendations for treating restless legs syndrome. Mov Disord. 2007;22(Suppl 18):S466–S475.CrossRefPubMed
24.
Tison F, Crochard A, Leger D, Bouee S, Lainey E, El Hasnaoui A. Epidemiology of restless legs syndrome in French adults: a nationwide survey: the INSTANT Study. Neurology. 2005;65:239–246.CrossRefPubMed
25.
Lavigne GJ, Montplaisir JY. Restless legs syndrome and sleep bruxism: prevalence and association among Canadians. Sleep. 1994;17:739–743.PubMed
26.
Phillips B, Young T, Finn L, Asher K, Hening WA, Purvis C. Epidemiology of restless legs symptoms in adults. Arch Intern Med. 2000;160:2137–2141.CrossRefPubMed
27.
Weinstock L, Bosworth B, Scherl E, et al. Crohn’s disease is associated with restless legs syndrome: a new extraintestinal manifestation [ACG abstract 1115]. Am J Gastroenterol. 2008;103:S435–S436.CrossRef
28.
Earley CJ, Heckler D, Allen RP. Repeated iv doses of iron provides effective supplemental treatment of restless legs syndrome. Sleep Med. 2005;6:301–305.CrossRefPubMed
29.
Tursi A, Brandimarte G, Giorgetti G. High prevalence of small intestinal bacterial overgrowth in celiac patients with persistence of gastrointestinal symptoms after gluten withdrawal. Am J Gastroenterol. 2003;98:839–843.CrossRefPubMed
30.
Pimentel M, Chow EJ, Lin HC. Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome. Am J Gastroenterol. 2000;95:3503–3506.CrossRefPubMed
31.
Pimentel M, Chow EJ, Lin HC. Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome: a double-blind, randomized, placebo-controlled study. Am J Gastroenterol. 2003;98:412–419.PubMed
32.
Sharara AI, Aoun E, Abdul-Baki H, Mounzer R, Sidani S, ElHajj I. A randomized double-blind placebo-controlled trial of rifaximin in patients with abdominal bloating and flatulence. Am J Gastroenterol. 2006;101:326–333.CrossRefPubMed
33.
Kemna E, Pickkers P, Nemeth E, van der Hoeven H, Swinkels D. Time-course analysis of hepcidin, serum iron, and plasma cytokine levels in humans injected with LPS. Blood. 2005;106:1864–1866.CrossRefPubMed
34.
Nemeth E, Rivera S, Gabayan V, et al. Il-6 mediates hypoferremia of inflammation by inducing the synthesis of the iron regulatory hormone hepcidin. J Clin Invest. 2004;113:1271–1276.PubMed
35.
Nemeth E, Tuttle MS, Powelson J, et al. Hepcidin regulates cellular iron efflux by binding to ferroportin and inducing its internalization. Science. 2004;306:2090–2093.CrossRefPubMed
Metadata
Title
Celiac Disease Is Associated with Restless Legs Syndrome
Authors
Leonard B. Weinstock
Arthur S. Walters
Gerard E. Mullin
Stephen P. Duntley
Publication date
01-06-2010
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 6/2010
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-009-0943-9

Other articles of this Issue 6/2010

Digestive Diseases and Sciences 6/2010 Go to the issue

Original Article

Ascertainment of Colonoscopy Indication Using Administrative Data

Correspondence

Bladder Cancer Metastasis to Duodenum: An Unusual Presentation of Obscure GI Bleed

Original Article

A Comparison of High-Definition Versus Conventional Colonoscopes for Polyp Detection

Erratum

Erratum to: Furazolidone, Co-amoxiclav, Colloidal Bismuth Subcitrate, and Esomeprazole for Patients Who Failed to Eradicate Helicobacter pylori with Triple Therapy

Original Article

Temporal Expression of Cytokines in Rat Cutaneous, Fascial, and Intestinal Wounds: A Comparative Study

Original Article

Longest Form of CCTG Microsatellite Repeat in the Promoter of the CD2BP1/PSTPIP1 Gene Is Associated with Aseptic Abscesses and with Crohn Disease in French Patients
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits