Basically, I think three broad categories (within which are sub-groups) are being told they have Sjogren's.

One is the Serum Positive Group, which contains those with either a +ANA, with or without SSA and SSB and + Lip biopsy in the mix. Aggressive 'nonerosive' arthritis of the small joints, Sicca and systemic effects such as nephritis, dRTA etc. Many of this group has comorbid small fiber neuropathy.

Another is Sero-negative, and these people have + Lip Biopsy, Sicca....My bet is ALL of these people have PN, likely autonomic.

The other is Sero-negative, with negative Lip biopsy and Sicca....and quite possibly PN

There is a 4th group which if explored would have medication induced sicca. Let's ignore this group...since they usually won't go for diagnostics any way...they just insist they have SjS.

The 3 could be completely unrelated, all 3 have a 'Fibro' like presentation with aches, pains (due to PN), arthropathy due to proprioceptive problems which lead to accelerated joint wear, strains etc, and dysautonomia....therefore appearing very much the same, but, in reality, being very different.

The SjS of neuropathic origin IS different in pathogenesis than the SjS of exocrine and systemic inflammation.....The name needs to be changed. I believe in the near future, 5 years or so....The SjS of the first category will be assigned to the 'Lupus' category, and the idea that Lupus can simply be an ANA+ disease with ALL organ systems affected. I don't believe that Lupus or SjS or any disease can affect major organs and NOT produce small fiber.