ArticleBMJ open2019
Causes of albuminocytological dissociation and the impact of age-adjusted cerebrospinal fluid protein reference intervals: a retrospective chart review of 2627 samples collected at tertiary care centre.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- COVID-19 associated brain/spinal cord lesions and leptomeningeal enhancement: A meta-analysis of the relationship to CSF SARS-CoV-2.Journal of neuroimaging : official journal of the American Society of Neuroimaging · 2021Pooled it
- Cerebrospinal fluid in COVID-19: A systematic review of the literature.Journal of the neurological sciences · 2021Pooled it
- Review
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- Silent Damage, Delayed Symptoms: A Case of Breast Cancer Radiation-Induced Lumbosacral Plexopathy.Reports (MDPI) · 2026Article
- Normal pressure hydrocephalus plus atypical presentation with symptomatic resolution following the restoration of CSF flow: illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- Bilateral Vocal Cord Paralysis Following Influenza A: Case Report.Clinical case reports · 2026Article
- Guillain-Barré syndrome and albuminocytological dissociation: a narrative review.Annals of medicine and surgery (2012) · 2025Review
- Challenges in the Diagnosis and Management of the Miller Fisher Variant of Guillain-Barré Syndrome: A Case Report.Cureus · 2025Article
- Albuminocytologic Dissociation and the Impact of Age-Adjusted Cerebrospinal Fluid Protein Levels in Guillain-Barré Syndrome.Neurology international · 2025Article
- Nitrous Oxide as an Emerging Cause of Subacute Combined Degeneration and Polyneuropathy: A Two-Case Report.Cureus · 2024Article
- SARS-CoV-2-related Guillain-Barré syndrome requires comprehensive diagnostic and therapeutic care.Journal of medicine and life · 2024Article
- Suppression of inner ear signal intensity on fluid-attenuated inversion recovery magnetic resonance imaging in cats with vestibular disease.Journal of feline medicine and surgery · 2023Article
- Population-Based Evaluation of Total Protein in Cerebrospinal Fluid.Mayo Clinic proceedings · 2023Article
- An Unusual Case of Hereditary Neuropathy With Liability to Pressure Palsy: A Diagnostic Challenge.Cureus · 2023Article
- Article
- Case report on psychogenic nonepileptic seizures: A series of unfortunate events.Clinical case reports · 2022Article
- Facial Diplegia as the Sole Manifestation of Post-Vaccination Guillain-Barre Syndrome: A Case Report and Literature Review.The Neurohospitalist · 2022Article
- A Dorsal Epidural Herniated Disc Fragment Initially Presenting as Guillain-Barré Syndrome.Cureus · 2022Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe set out to test the discriminative power of an age-adjusted upper reference limit for cerebrospinal fluid total protein (CSF-TP) in identifying clinically relevant causes of albuminocytological dissociation (ACD).
methodsWe reviewed the charts of 2627 patients who underwent a lumbar puncture at a tertiary care centre over a 20-year period. Samples with CSF-TP above 45 mg/dL (0.45 g/L) were included. Samples with white cell count >5×10
resultsThe presence of ACD was associated with a broad range of neurological diagnoses. Among all 2627 patients with ACD, a clinical diagnosis explaining CSF-TP elevation was identified in 57% of cases. 'True' ACD was associated with a suitable diagnosis in 75% of cases, whereas patients with 'pseudo' ACD showed an appropriate diagnosis in only 51% of cases. Use of an age-adjusted upper reference limit favoured the detection of polyneuropathy patients (13.5% proportionate increase) and excluded a larger number of patients with isolated headache (10.7% proportionate decrease; p<0.0001).
conclusionsElevated CSF-TP is a common finding, with a range of underlying causes. Use of an age-adjusted upper reference limit for the CSF-TP value improves diagnostic specificity and helps to avoid overdiagnosis of ACD.
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