Chatsiz et al. found quadruple autoantibody negativity in 4.6% of patients, and when their patients with quadruple autoantibody negative were compared with antiSSA/Ro positive controls, regardless of RF or antiSSB/La status, persistent lymphadenopathy and lymphoma were observed to be less common in the group with quadruple antibody negativity [8]. The gene discussed is CALR; the disease is lymphoma.