I am going to bring this thread back to the foreground again. I have been in another forum for Sjogren's and I want to make things clear.

There is Sicca and Sjogren's.

Many, many drugs cause sicca. Dry mouth, dry eyes.

Among them are antidepressants, all of them. Benzodiazepines (during withdrawal too) , z drugs, antiparkinsonian drugs, diuretics, opiates.

If you are on these drugs, have negative blood work such as a normal ANA, normal ENA, and a lip biopsy is negative...look at the drugs. They should look at drugs FIRST before they do tests. It is easier to go off these drugs and see if things improve, than to go thru all that testing and have it come back negative.

Not all sicca is Sjogren's. Not all Sicca is inflammatory. Not all fatigue is autoimmune.

Many diseases come with sicca because sicca can be neurological as well as inflammatory.

When people seek to label their sicca as Sjogren's they do themselves a disfavor. They may not find out what the cause of the sicca is. I would hate to mistake SjS for amyloidosis!

I know what it is like to be anxious for a diagnosis, but, to be accurate, is what is most important.

Sicca is NOT Sjogren's. Primary SjS is worse than secondary SjS and the term secondary SjS should be dropped unless the blood work is +, because, all autoimmune disease can produce Sicca. Sicca is part of RA, Lupus etc. People with autoimmune disease already have the aching, the fatigue etc that come with any AI disease.

Primary SjS can make people very, very sick. Sicca is uncomfortable but not life threatening. Primary SjS can be.

Rheumatology needs to decide what is what....they have tried to classify autoimmune disease by the ENA, when it should simply be the ANA being +. They need to realize that many of the ENA do not define the disease. Only a certain percentage of people have the 'correct' antibody for their disease. However, at least elevated ANA, low complements, high sed rates, high CRP, thrombocytosis indicates inflammation. Without these markers, it is hard to assign sicca to an inflammatory cause.

Lip biopsies can show inflammation but it is not always SjS.

SjS diagnosis is a mess.