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Maria Stella Graziani

Deputy Director
Martina Zaninotto

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

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Francesco Busardò

International Advisory Board Khosrow Adeli Canada
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Giuseppe Agosta

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

BC: Articoli scritti da B.M. Mongiardo

Mielopatia di incerto significato
A myelopathy of uncertain origin
<p>In November 2013, following a febrile episode lasting for one week, a 51-year-old&nbsp;male reported fatigue and increasing clumsiness and rigidity of lower limbs. Two months after the symptoms onset,&nbsp;neurological examination showed ataxic-spastic gait, diffuse accentuation of deep tendon reflexes with extensor&nbsp;plantar response and abolition of the abdominal reflexes. The clinical suspicion of an autoimmune para-infectious&nbsp;myelo-neuropathy, prompted us to a comprehensive clinical chemistry, hematology and autoimmunity work-up: the only&nbsp;pathological result was an IgG monoclonal gammopathy. Nerve conduction studies showed a very mild sensory&nbsp;neuropathy, while visual evoked potentials were abnormal. Contrast magnetic resonance imaging showed a contrastfree&nbsp;parenchymal C2 spinal cord lesion. Cerebrospinal fluid examination, obtained to rule out multiple sclerosis (MS),&nbsp;demonstrated a moderate barrier disruption without oligoclonal bands reaction. These features rule out MS suggesting&nbsp;Devic&#39;s disease (neuromyelitis optica). Additional serological testing to detect aquaporin-4 antibodies (NMO-IgG) was&nbsp;positive, underscoring the paramount importance of laboratory testing in this differential diagnosis.</p>
Biochimica Clinica ; 39(5) e13-e15
Casi clinici - Case report