Signs of an autonomic nervous system dysfunction involving the cardiovascular system can be discerned in the majority of anti-SSA/Ro- and anti-SSB/La-positive patients with CTD [3]; on this basis, a putative role for cardiovascular autonomic dysfunction in favoring an adverse outcome of complete heart block by impairment of compensatory shock mechanisms as was seen in the present patient, cannot be ruled out. Here, CALR is linked to Abnormal autonomic nervous system physiology.