In Patient 1, with extremely high levels of aCL IgG (832.9 GPL) and aB2GPI IgG (4000.5 GPL), long-segmental diffuse narrowing of the left ICA progressed, despite treatment with vitamin K antagonists, aspirin, hydroxychloroquine, and (high-dose) systemic glucocorticoids for possible vasculitis (Figure 3A). The gene discussed is ACLY; the disease is vasculitis.