CTLA4 and autoimmune disease: To avoid the possibility of a false positive association of CTLA-4 +49A/G*A with pSS as a result of the somewhat small sample size of our first cohort, and because the CTLA-4 +49A/G*A allele has been only marginally associated with autoimmune diseases compared with the CTLA-4 +49A/G*G allele [1], we performed a replication study on a second independent cohort of 139 patients with pSS.