CRYOGLOBULINEMIC NEUROPATHY MANIFESTING WITH RESTLESS LEGS SYNDROME

In a series of 12 patients with essential mixed cryoglobulinaemia (EMC ) and peripheral neuropathy as main feature of the disease, restless l egs syndrome (RLS) was a major manifestation in four women, aged 55-65 years. In one patient RLS was a presenting manifestation of the disea se, and in another patient the diagnosis of EMC was made investigating RLS and polyneuropathy, although prior rheumatological symptoms were retrospectively recognized. All patients with RLS had symmetrical sens ory polyneuropathy, but non-RLS patients had also other forms of perip heral neuropathy, and symmetrical sensory polyneuropathy only in two o f eight cases (P=0.03). Neurophysiological study showed that sensory a ction potentials of the sural nerve were more often inelicitable in no n-RLS patients (six of eight) than in RLS patients (none of three). Su ral nerve biopsy had no distinctive features in three RLS patients, wi th regard to other patients with cryoglobulinaemic neuropathy. RLS see ms not uncommon in cryoglobulinaemic neuropathy, and significantly ass ociated with symmetrical sensory polyneuropathy, whereas patients with other subtypes of cryoglobulinaemic neuropathy do not develop RLS; th us, a disorder of the sensory inputs may be important in the pathogene sis of RLS. The occurrence of RLS, especially in middle-aged women, sh ould prompt investigations for peripheral neuropathy focusing on cryog lobulinaemic neuropathy. (C) 1997 Elsevier Science B.V.