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Neue Aspekte zur Eisentherapie des RLS in der Praxis – Teil 1

Ist eine schnelle Umsetzung entscheidend für die Lebensqualität der Patienten?

New Aspects Regarding Iron Treatment for RLS in Daily Practice—Part 1

Is Rapid Implementation Crucial for Patient Quality of Life?

  • Neurologie
  • Published:
psychopraxis. neuropraxis Aims and scope Submit manuscript

Zusammenfassung

Die gegenwärtigen pathophysiologischen Erkenntnisse zum Fe-Mangel im Gehirn beim RLS favorisieren eine Fe-Behandlung als „First-Line-Therapie“, als orale Fe-Gabe oder intravenöse (FCM-)Applikation. Die „spezifischen“ Serum-Ferritin-Spiegel, Fe-Spiegel und die der Transferrinsättigung sind in der Praxis richtungsweisend. Insbesondere bei Frauen war die Responderrate umso höher, je niedriger das Serumeisen war (80,5 ± 26,7 vs. Nonresponder 95,8 ± 30,5 µg/dl) und die prozentuale Transferrinsättigung [% TSAT] (25,4 % vs. Nonresponder 30,5 %). Im Allgemeinen sagt eine niedrigere %TSAT eine bessere Chance voraus, dass insbesondere Frauen auf eine i.v. Fe-Behandlung ansprechen. Nur durch die Kenntnis eines „nichtanämischen Fe-Mangels (NAID)“ beim RLS-Patienten werden die Weichen zur Fe-Therapie gestellt.

Abstract

Current pathophysiological knowledge of iron (Fe) deficiency in the brain in restless legs syndrome (RLS) favours Fe treatment as “first-line therapy”, oral Fe administration or intravenous (ferric carboxymaltose, FCM) application. The “specific” serum ferritin levels, Fe levels and those of transferrin saturation are indicative in practice. In particular, in women, the lower the serum iron (80.5 ± 26.7 vs. nonresponders 95.8 ± 30.5 µg/dl) and the percentage transferrin saturation (% TSAT) (25.4% vs. nonresponders 30.5%), the higher the responder rate. In general, a lower %TSAT predicts a better chance that women in particular will respond to intravenous Fe treatment. Knowledge about “nonanaemic iron deficiency (NAID)” in the RLS patient is required to start Fe therapy.

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  1. Hochwaldstraße 2, 97769, Bad Brückenau, Deutschland

    Hans-Klaus Goischke

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Correspondence to Hans-Klaus Goischke.

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Goischke, HK. Neue Aspekte zur Eisentherapie des RLS in der Praxis – Teil 1. psychopraxis. neuropraxis 24, 247–252 (2021). https://doi.org/10.1007/s00739-021-00724-1

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