In recent years, seronegative APS was proposed and defined as the presence of APS criteria manifestations, coexistence of “non-criteria” manifestations, but persistently negative criteria antiphospholipid antibodies [6]. The non-criteria antiphospholipid antibodies raised include aPE, anti-phosphatidylserine/prothrombin, anti-vimentin, anti-annexin V and II antibodies [7–10]. Here, ANXA5 is linked to autoimmune polyendocrinopathy.