Indeed, patients with systemic lupus and isolated Ro52 Ab seemed to have more severe symptoms, with more renal involvement and necessity of a higher number of lines of treatment, whereas patients with Ro52 and Ro60 Ab were more susceptible to hematologic complications as found by Menendez et al. (46) Patients with Sjögren's syndrome and Ro52 Ab also seemed to have more severe symptoms with more renal insufficiency and anemia as found by Retamozo et al. (patients with Sjögren's syndrome and high titer of Ro52 Ab had more anemia and leukopenia) (47). This evidence concerns the gene TRIM21 and Renal insufficiency.