ALB and hereditary elliptocytosis: Notably, although this study did not investigate the physiopathology of HE in depth, the concomitant elevations in albumin and glutamine levels in CSF could suggest, but does not prove (because we do not analyze albumin in serum), a dual pathway contributing to HE: one reflecting structural disruption of the BBB or choroid plexus (albumin) and the other indicating astrocytic metabolic overload and edema (glutamine) [57,58].