Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Psychiatry. Jun 19, 2026; 16(6): 116253
Published online Jun 19, 2026. doi: 10.5498/wjp.v16.i6.116253
Published online Jun 19, 2026. doi: 10.5498/wjp.v16.i6.116253
Diagnostic challenges in restless abdomen syndrome: A case report
Li-Shan Ren, Zheng-He Yu, Hong-Jing Mao, Wen-Juan Liu, Department of Sleep Medicine, Affiliated Mental Health Center & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang Province, China
Author contributions: Ren LS conceptualized and designed this work; Mao HJ participated in the design; Liu WJ and Yu ZH contributed to patient involvement and investigation; Ren LS drafted the original manuscript; Liu WJ, Yu ZH, Mao HJ, and Ren LS participated in the review and editing of the manuscript. All authors have read and approved the final manuscript.
AI contribution statement: During the preparation of this manuscript, the authors used the Gemini-3.1-Pro model only to improve the readability and language quality of the text (e.g., grammar correction and language polishing). After using this tool, the authors reviewed and edited the output, and take full responsibility for the final content of the publication. We confirm that the AI tool was not used to generate any scientific content. The experimental design, data interpretation, and core manuscript (including the abstract, methods, results, and discussion) were entirely and independently completed by the research team. Furthermore, all figures and tables are original to this study, with no AI-generated images.
Supported by the Hangzhou Special Project for Biomedical and Health Industry, No. 2024WJC034 and No. 2023WJC189; and Major projects of Hangzhou Municipal Health Commission, No. Z20250275.
Informed consent statement: Written informed consent was obtained from the patient and her legally authorized representative for the publication of this case report in accordance with the journal’s patient consent policy.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Wen-Juan Liu, Associate Chief Physician, Department of Sleep Medicine, Affiliated Mental Health Center & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, No. 305 Tianmushan Road, Hangzhou 310013, Zhejiang Province, China. juan_2001juan@163.com
Received: November 7, 2025
Revised: January 12, 2026
Accepted: March 4, 2026
Published online: June 19, 2026
Processing time: 202 Days and 18.8 Hours
Revised: January 12, 2026
Accepted: March 4, 2026
Published online: June 19, 2026
Processing time: 202 Days and 18.8 Hours
Core Tip
Core Tip: Restless abdomen syndrome is an under-recognized variant of restless legs syndrome characterized by abdominal discomfort worsening at rest. This report describes a patient previously misdiagnosed with anxiety-induced insomnia. A novel finding was isolated hypotransferrinemia despite normal ferritin, suggesting a specific deficit in blood-brain barrier iron transport. The patient achieved complete remission with the dopamine agonist pramipexole. This report underscores the diagnostic value of the circadian symptom pattern and suggests that transferrin levels may offer mechanistic insights into restless legs syndrome variants, alerting clinicians to avoid misdiagnosing this treatable condition as a psychiatric disorder.