ALB and myeloid sarcoma: A recent study also investigated the relationship between IRLs and clinical, MRI and CSF profiles.18 Besides an association of IRLs with worse disease severity and lower brain volumes, the authors also found a pathologically elevated albumin quotient as a marker of blood–CSF barrier disruption in MS patients with IRLs.18 We now provide some additional observations regarding the association between IRLs, pathogenic CSF profiles and a CSF-related tissue injury.