Due to refractory anemia and exertional dyspnea, he admitted to our hospital in October 2019, he had marked anemia (Hb 6.7 g/dL), elevated CRP (13.2 mg/dL), excess IL-6 (60.6 pg/mL), elevated total protein (11.3 g/dL), hypoalbuminemia (2.3 g/dL), renal dysfunction (blood urea nitrogen 37 mg/dL, serum creatinine 2.3 mg/dL, creatinine clearance 35 mL/min) elevated ferritin (477 ng/mL) as well as hypergammaglobulinemia (Immunoglobulin [Ig]G 6585 mg/dL, IgA 809 mg/dL, IgM 195 mg/dL, IgG4 1240 mg/dL) without monoclonal peak on immunoelectrophoresis in either serum or urine. Here, CD40LG is linked to anemia.