{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T06:25:45Z","timestamp":1787120745481,"version":"build-2736575974"},"reference-count":10,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Graves' disease may rarely present with predominant neuropsychiatric symptoms, such as severe, treatment\u2010resistant panic attacks, leading to misdiagnosis as a primary psychiatric disorder. We describe a 30\u2010year\u2010old woman with refractory panic attacks and night terrors who was initially treated with anxiolytics and antidepressants. Despite fluctuating thyroid function test results, which raised diagnostic uncertainty between evolving hyperthyroidism and thyroiditis, the presence of ophthalmopathy and autonomic hyperactivity prompted further evaluation. Thyroid scintigraphy demonstrated diffuse uptake consistent with Graves' disease and effectively excluded thyroiditis, allowing prompt initiation of antithyroid therapy and propranolol. Following treatment, the patient showed significant clinical improvement with resolution of autonomic symptoms. This case highlights the diagnostic challenge of atypical Graves' disease presentations and emphasizes the importance of considering endocrine causes in refractory neuropsychiatric symptoms. Functional imaging, alongside careful clinical assessment, may help resolve clinical\u2013biochemical discrepancies and support timely diagnosis in selected patients with atypical presentations.<\/jats:p>","DOI":"10.1002\/ccr3.73055","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T21:57:47Z","timestamp":1782943067000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Graves' Disease Presenting as Refractory Panic Attacks: Diagnostic Clarification Through Thyroid Scintigraphy"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0050-3314","authenticated-orcid":false,"given":"Mahsa Satari","family":"Gholami","sequence":"first","affiliation":[{"name":"Cardiovascular Nursing Research Center Rajaie Cardiovascular Institute  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010020\u20100184\u2010y"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0229"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2165\/00023210\u2010200620110\u201000003"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13030\u2010021\u201000211\u20104"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13215277"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000490384"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.120.243170"},{"key":"e_1_2_10_9_1","first-page":"S902","volume-title":"European Journal of Nuclear Medicine and Molecular Imaging","author":"Nakro D.","year":"2024"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.4103\/0976\u20103147.165393"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.31579\/2578\u20108868\/359"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73055","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.73055","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73055","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:35:03Z","timestamp":1787117703000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.73055"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":10,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/ccr3.73055"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.73055","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-02-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73055"}}