CALR and Hypokalemia: Though dynamic imaging of salivary glands (nuclear medicine imaging) showed that the uptake, secretion and excretion of the glands were generally normal, there have been some reported cases of SS with MCD,[7] which studies have indicated that TIN usually occurs before sicca symptoms and increases the possibility of worsening renal function.[8] Given the patient’s history of persistent hypokalemia and alkaline urine, combined with the strongly positive indicators of anti-SSA/Ro52 (+++) and anti-SSB (++), highly suspected SS.