1496 Restless Legs Syndrome in a Pediatric Patient: A Rare Complication Following Glomerulonephritis

Likhita Shaik; Janey Dudley; Daniel Rongo; Anna Wani

doi:10.1093/sleep/zsaf090.1496

Introduction Restless Legs Syndrome (RLS) is a neurological disorder characterized by an irresistible urge to move the legs, often accompanied by uncomfortable sensations. In pediatric populations, RLS is less common, with studies suggesting a prevalence of 2-4%[1,2]. Although 12-35% of pediatric chronic kidney disease patients experience RLS symptoms, the incidence of RLS with glomerulonephritis is much lower, with only a few documented cases in the literature[3,4]. Therefore, the association of RLS in a child with glomerulonephritis is an unusual presentation, making this case particularly noteworthy. Report of case A 9-year-old male presented with difficulty falling asleep, maintaining sleep, and feeling fatigued despite adequate sleep hours since a year. These symptoms coincided with his recent diagnosis of glomerulonephritis following recurrent streptococcal infections. Despite undergoing tonsillectomy and adenoidectomy to treat these recurrent infections, the patient continued to experience significant daytime sleepiness, often falling asleep at school or in the car. The parents also reported frequent leg twitches, jerks, sleepwalking, and nocturnal eating episodes which cycled into restless and non-refreshing sleep. The patient’s sleep study revealed no signs of sleep apnea, however showed reduced REM sleep (9.1%), low sleep efficiency (54%), increased sleep onset latency (190 minutes), and an arousal index of 7.5. These findings suggested significant sleep disruption, due to the patient’s leg movements. Given the timing of his symptoms following the diagnosis of glomerulonephritis, RLS was suspected. Subsequent testing for ferritin level was found to be 56 ng/mL, which was slightly below optimal levels for his age. Treatment with a multivitamin containing iron and gabapentin led to significant improvements in his sleep quality and daytime symptoms. Parasomnias and leg twitches improved, and restorative sleep resulted. Conclusion This case highlights the rare occurrence of RLS following glomerulonephritis in a pediatric patient, underscoring the importance of considering neurological symptoms in children with kidney disease. Further research is needed to explore the potential link between renal conditions and RLS in pediatric populations.

1496 Restless Legs Syndrome in a Pediatric Patient: A Rare Complication Following Glomerulonephritis

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