At the annual visit to rheumatologist in 2019, the patient presented with nephrotic syndrome based on proteinuria (urine albumin-to-creatinine ratio 913 g/mol; reference <3.0 g/mol) and low plasma albumin (16 g/L) whereas renal function apparently was preserved (estimated glomerular filtration rate based on plasma creatinine according to MDRD: >90 mL/min/1.73 m2). The gene discussed is ALB; the disease is nephrotic syndrome.