A 61-year-old woman presented progressive distal weakness and wasting
of her upper limbs spreading to the shoulder girdle and to the neck mu
scles. Creatine kinase, cerebrospinal fluid, spinal X-ray and spinal n
uclear magnetic resonance were normal. Electromyography showed myopath
ic alterations. Muscle biopsy showed abundant rods in many fibres. Pre
dnisone 75 mg/die for two months did not modify the symptoms.