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Editor-in-chief
Maria Stella Graziani

Deputy Director
Martina Zaninotto

Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

EIC Assistant
Francesco Busardò

International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
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Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
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Publisher
Biomedia srl
Via L. Temolo 4, 20126 Milano

Responsible Editor
Giuseppe Agosta

Editorial Secretary
Chiara Riva
Biomedia srl
Via L. Temolo 4, 20126 Milano
Tel. 0245498282
email: biochimica.clinica@sibioc.it

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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091

BC: Articoli scritti da V. Durastanti

Mielopatia di incerto significato
A myelopathy of uncertain origin
M.T. Muratore \| R. Buzzi \| R. Carrozza \| B.M. Mongiardo \| V. Durastanti \| G. Salvatori \|
<p>In November 2013, following a febrile episode lasting for one week, a 51-year-old male reported fatigue and increasing clumsiness and rigidity of lower limbs. Two months after the symptoms onset, neurological examination showed ataxic-spastic gait, diffuse accentuation of deep tendon reflexes with extensor plantar response and abolition of the abdominal reflexes. The clinical suspicion of an autoimmune para-infectious myelo-neuropathy, prompted us to a comprehensive clinical chemistry, hematology and autoimmunity work-up: the only pathological result was an IgG monoclonal gammopathy. Nerve conduction studies showed a very mild sensory neuropathy, while visual evoked potentials were abnormal. Contrast magnetic resonance imaging showed a contrastfree parenchymal C2 spinal cord lesion. Cerebrospinal fluid examination, obtained to rule out multiple sclerosis (MS), demonstrated a moderate barrier disruption without oligoclonal bands reaction. These features rule out MS suggesting Devic's disease (neuromyelitis optica). Additional serological testing to detect aquaporin-4 antibodies (NMO-IgG) was positive, underscoring the paramount importance of laboratory testing in this differential diagnosis.</p>
Biochimica Clinica ; 39(5) e13-e15 Casi clinici - Case report