Restless legs syndrome in lung chemical warfare patients

Abstract

BACKGROUND: Restless legs syndrome (RLS) has been associated with a variety of diseases, including chronic obstructive pulmonary disease (COPD), which can worsen the symptoms of underlying disease and correlates with co-morbidities. We aimed to investigate RLS in patients with chemical warfare-induced lung diseases. METHODS: This cross-sectional study recruited patients with sulfur mustard (SM) lung injury, their healthy family members, and patients with COPD from August 2018 to August 2019. COPD was confirmed by medical history, physical examination, and spirometry according to GOLD COPD guidelines. RLS diagnosis was recognized by the International Restless Legs Syndrome Study Group (IRLSSG) and severity was assessed using the International Restless Legs Scale (IRLS) rating scale. Other research measures were COPD Assessment Test (CAT), modified Medical Research Council (mMRC) scale for dyspnoea severity, and Epworth Sleepiness Scale (ESS) for daytime somnolence. Laboratory values included hemoglobin, ferritin, creatinine, and fibrinogen. RESULTS: This study was conducted on 143 men in three groups: 40 (30.0%) SM-exposed veterans, 73 (55.3%) patients with COPD, and 30 (20.9%) healthy cases. Due to the high prevalence of COPD and better comparison with the control group, more patients with COPD were selected. 20 cases (50%) of the veterans group had RLS, while 25 (32.9%) cases of COPD were affected by this disorder. One normal case (3.33%) suffered from RLS. The chemical veterans who suffered from cough, sputum production, chest pain, and hemoptysis had a higher incidence in proportion to patients with COPD (P < 0.001). The CAT score was significantly higher in SM-exposed veterans with RLS (P = 0.004). CONCLUSION: RLS is more common in SM lung injuries with higher CAT scores; therefore, evaluation and treatment of RLS are recommended in mustard lung victims.

Keywords

• lung
• chemical warfare
• chronic obstructive pulmonary disease