The patient with SLE carried a rare heterozygous missense variant in the TNF receptor superfamily co-stimulator TNFRSF4/OX40, substituting a signaling peptide residue in the hydrophobic region relatively conserved in mammals (p.R10C) with a CADD score of 22 predicting functional consequences (Supplemental Figure 5 a+b). The gene discussed is TNFRSF4; the disease is systemic lupus erythematosus.