Plasma R Binder Deficiency

To the Editor: Another perspective on the report on plasma R binder deficiency and neurologic disease (Nov. 19 issue)¹ may be useful. The authors' construction of a parallel between their case and my four cases of R binder deficiency^{2 3 4} is problematic for several reasons. To begin with, the two disease entities were not the same. My patients (and one described by Zittoun et al.⁵) lacked R binder in all fluids and tissues, as required for the diagnosis of true R binder deficiency, whereas the patient of Sigal et al. did not. Universal absence suggests a hereditary abnormality of R.