Your activity: 6 p.v.

Algorithm for the diagnosis and management of pediatric restless legs syndrome

Algorithm for the diagnosis and management of pediatric restless legs syndrome
Dotted arrows: Proceed only after assessment of severity, risks, and benefits by provider, family, and patient. Refer to UpToDate topic text for further details.
RLS: restless legs syndrome; ADHD: attention deficit hyperactivity disorder; TIBC: total iron-binding capacity.
* Serum ferritin is an acute-phase reactant and is not accurate within 4 weeks of a febrile illness or in the setting of chronic inflammation. At the initial evaluation, we typically also check hemoglobin, TIBC, and percent iron saturation for a more complete profile of the child's iron status. For guidance on interpreting these tests, refer to the UpToDate topic review on iron deficiency in children and adolescents.
¶ For adults with RLS, oral iron therapy is recommended if serum ferritin is <75 mcg/L. For children with RLS, oral iron is recommended if serum ferritin is <50 mcg/L and may be considered if it is in the 50 to 75 mcg/L range. If ferritin is >100 mcg/L, oral iron typically is not effective, due to hepcidin-induced limitation of iron absorption. Ferritin >100 mcg/L also may reflect acute or chronic inflammation.
Δ Refer to UpToDate topic text for details about selection and dosing of medications, and for other considerations for children <6 years of age and those with comorbid ADHD, anxiety, or depression.
Modified with permission from the Restless Legs Syndrome Foundation (www.rls.org). Copyright © 2015.
Graphic 99432 Version 5.0