Guillain–Barré syndrome and albuminocytological dissociation: a narrative review

Guillain–Barré syndrome (GBS) is an aggressively advancing rapidly autoimmune disorder often triggered by a recent infection that attacks the peripheral nerves, ultimately leading to diminished reflexes, sensory abnormalities, and muscle weakness. Albuminocytological dissociation (ACD), defined as a cerebrospinal fluid (CSF) evaluation depicting normal white blood cell counts, but high protein levels are considered as a pathognomonic feature in the diagnosis of GBS. While ACD has been well-reported in the available literature, its exact cause and etiology remain uncertain; however, some hypothesis suggests inflammation, disrupted nerve barrier function, and altered CSF flow contributes to the pathogenesis of ACD. In this narrative review, we aim to assess its diagnostic value, a viable source in predicting disease severity and evaluate the pathophysiological association between ACD and GBS. We also highlight recent advancements in CSF biomarker research and proteomics that could refine and further improve the diagnosis and treatment of GBS. By consolidating existing knowledge, this review seeks to improve clinical awareness of ACD, guide future investigations, and contribute to better patient management strategies.