{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:51:48Z","timestamp":1788306708909,"version":"build-2803163510"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005788","name":"Medical University of Vienna","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Albuminocytologic dissociation in cerebrospinal fluid (CSF) is a diagnostic hallmark of Guillain\u2013Barr\u00e9 syndrome (GBS). Compared to CSF total protein (TP), the CSF\/serum albumin quotient (Qalb) has the advantage of method-independent reference ranges. Whether the diagnostic yield differs between Qalb and CSF-TP is currently unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed the diagnostic yield (i.e., a value above the URL indicating blood\u2013nerve barrier dysfunction) of Qalb and CSF-TP levels in patients with GBS. We evaluated two different equations (Reiber\u2019s and Hegen\u2019s) for age-adjusted URLs of Qalb and compared results to CSF-TP using the standard URL of 0.45\u00a0g\/L as well as age-adjusted URLs (by decade of age). Additionally, multivariable logistic regression analysis was used to assess the effect of clinical factors on the diagnostic yield.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We analyzed 110 patients [62% males; median age 48 (IQR 35\u201358)] with sensorimotor (68), motor (16), sensory (12) and localized (8) GBS as well as Miller Fisher syndrome (6).<\/jats:p>\n                    <jats:p>\n                      Qalb and CSF-TP were highly correlated (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The diagnostic yield of Qalb was 65% with Reiber\u2019s and 47% with Hegen\u2019s age-adjusted URLs compared to 66% with the fixed CSF-TP URL of 0.45\u00a0g\/L and 49% with age-adjusted CSF-TP URLs. A longer duration from clinical onset to lumbar puncture was associated with a higher diagnostic yield.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Qalb strongly correlates with CSF-TP in patients with GBS with a similar diagnostic yield for the detection of a blood\u2013nerve barrier dysfunction. However, the diagnostic yield of both values is lower when using more recent age-adjusted URLs and at earlier timepoints.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-021-10479-9","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T03:02:57Z","timestamp":1614654177000},"page":"3294-3300","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Cerebrospinal fluid analysis in Guillain\u2013Barr\u00e9 syndrome: value of albumin quotients"],"prefix":"10.1007","volume":"268","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6581-4572","authenticated-orcid":false,"given":"Jakob","family":"Rath","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gudrun","family":"Zulehner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernadette","family":"Schober","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Grisold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Krenn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakan","family":"Cetin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fritz","family":"Zimprich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"10479_CR1","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1038\/s41582-019-0250-9","volume":"15","author":"SE Leonhard","year":"2019","unstructured":"Leonhard SE, Mandarakas MR, Gondim FAA et al (2019) Diagnosis and management of Guillain-Barr\u00e9 syndrome in ten steps. 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The requirement to obtain patient consent was waived for this retrospective study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All authors read and approved the final manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}]}}