C4A and cryoglobulinemia: Prognostic markers that are associated with severe extra-glandular disease include hypocomplementia (C3 and C4), cryoglobulinemia, monoclonal gammopathy, anti-Ro, anti-La, RF, and hypergammaglobulinemia, most of which were also present in our patient [5, 6, 9, 10].