Workup performed to rule out other differentials included negative blood work for glucose, lipid profile, TSH, vitamins E, B12, folate, ACE, syphilis, HIV, Hepatitis, copper, serum protein electrophoresis with immunofixation, ceruloplasmin, SCA panel, ENA/ANA/ANCA panel, CSF oligoclonal bands, paraneoplastic panel, GM1 and GD1b antibodies, GQ1b Ab, and MAG Abs [1,2,3,4,5]. The gene discussed is ACE; the disease is syphilis.