Enteropathy is reported in up to 78% of cases and was present in both P6 and P7.19 Interstitial lung disease was also present in P6 and is reported in 66% of CTLA4 cases.19 Autoimmune haemolytic anaemia and immune thrombocytopenia are also commonly encountered at 28% and 35% of cases, respectively, and psoriasis 21% of cases,19 all of which were also present in P7. The gene discussed is CTLA4; the disease is autoimmune hemolytic anemia.