However, reduced levels of RCL-cleaved CBG inferred from ELISA measurements in patients with abdominal obesity (Nenke et al. 2016a), alpha-1-antitrypsin deficiency (Nenke et al. 2016b) and active rheumatoid arthritis (Nenke et al. 2016c) are paradoxical and hard to reconcile because activated neutrophils in these patients would be expected to increase CBG cleavage. The gene discussed is SERPINA1; the disease is hyperinsulinemic hypoglycemia, familial, 4.