{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:35:00Z","timestamp":1787243700419,"version":"build-2736575974"},"reference-count":21,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Background: This study examined the impact of age-adjusted cerebrospinal fluid (CSF) protein levels on clinical characteristics, disease severity, and outcomes in Guillain\u2013Barr\u00e9 Syndrome (GBS) patients. Methods: This retrospective study included 71 GBS patients at UTMB Galveston. Albuminocytologic dissociation (ACD) was defined as CSF\u2013total protein (CSF-TP) &gt;0.45 g\/L with a cell count of &lt;50 cells\/L. Patients were grouped using the conventional cutoff (&gt;0.45 g\/L) and age-adjusted upper limits (URLs) for CSF-TP levels, comparing clinical, CSF, and electrophysiological characteristics across groups. Results: The mean age was 50 years (SD = 14.5). The mean age of patients with a CSF-TP &gt; 45 g\/L was higher (53 vs. 39 years, p = 0.000), whereas no such difference was noted using age-dependent URLs. Using age-adjusted CSF-TP URLs reduced the sensitivity for detecting ACD by 20%. CSF-TP &gt; age-adjusted URLs were associated with lower MRC sum scores (39 vs. 47.43, p = 0.000), higher ICU admission rates (34% vs. 20%, p = 0.003), and the need for second-line treatment (41% vs. 17%, p = 0.049), and the trends were not observed with the conventional cutoff of 0.45 g\/L. CSF-TP was an independent predictor of lower MRC sum scores (p = 0.009, 95% CI \u22120.058, \u22120.009) and higher GBS disability scores (p = 0.015, 95% CI 0.000, 0.004). Conclusions:\u00a0ACD is a common finding in GBS, but normal protein levels do not exclude the diagnosis. Using age-adjusted URLs might improve specificity but reduce sensitivity for ACD detection, potentially increasing false negatives. CSF-TP levels exceeding age-adjusted URLs were more strongly associated with greater disease severity and poorer outcomes compared to the conventional cutoff of 0.45 g\/L.<\/jats:p>","DOI":"10.3390\/neurolint17020018","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T06:17:52Z","timestamp":1737699472000},"page":"18","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Albuminocytologic Dissociation and the Impact of Age-Adjusted Cerebrospinal Fluid Protein Levels in Guillain\u2013Barr\u00e9 Syndrome"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2648-7796","authenticated-orcid":false,"given":"Nithisha","family":"Thatikonda","sequence":"first","affiliation":[{"name":"Department of Neurology, University of Texas Medical Branch, Galveston, TX 77550, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru","family":"Lerint","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Texas Medical Branch, Galveston, TX 77550, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaitra","family":"Takle","sequence":"additional","affiliation":[{"name":"John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX 77550, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Texas Medical Branch, Galveston, TX 77550, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9809-1016","authenticated-orcid":false,"given":"Chilvana","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Texas Medical Branch, Galveston, TX 77550, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1002\/ana.410270707","article-title":"Assessment of current diagnostic criteria for Guillain-Barr\u00e9 syndrome","volume":"27","author":"Asbury","year":"1990","journal-title":"Ann. 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