=====Sjogrens Syndrome=====
  *autoimmune disease
    *Ab's to the Ro/SSA and La/SSB antigens,(which are also found in other autoimmune diseases) cryoglobulinemia, hypocomplementemia
    *propensity to develop non-Hodgkin lymphoma
  *often diagnosed during Ix of neuropathies, nephropathies, interstitial pneumonitis, hematologic abnormalities, lymphoproliferative changes
  *mild to moderate disease sometimes with lack of salivary involvement and more extra-salivary presentation

==Clinical==
  *dry eyes, mouth, skin & vagina
  *fatigue
  *muscle, joint pain
  *salivary gland inflammation and swelling
  *rashes exacerbated by UV exposure

=====Systemic Lupus Erythematosus (SLE)=====
  *chronic autoimmune disease of unknown cause that can affect virtually any organ of the body.
  *Immunologic abnormalities, esp of antinuclear antibodies (ANA).
  *variable clinical features ranging from mild joint and skin involvement to life-threatening kidney, haematologic, or CNS involvement
  *fatigue, fever, myalgia and weight changes (both LOW and weight gain with fluid shifts assoc with low Alb)
  *Arthritis and arthralgias in over 90% - moderately painful, usually does not cause erosion, and rarely deforming
  *muco-cutaneous changes - highly variable but butterfly rash on face = common, and photosensitive rashes Painless ulcers
  *vasculitis including Raynaud's
  *thrombo-embolic disorders - both arterial and venous circulation
  *GI, resp, CNS, blood dyscrasias

===Investigations===
aside from routine bloods, which may be abnormal, other supportive tests include:
  *Serum protein electrophoresis esp if hypergammaglobulinemia - suggestive of systemic inflammatory process
  *ANA (ideally by indirect immunofluorescence testing) - usually +ve in all SLE patients at some time. If +ve should then test for - anti-dsDNA, anti-Smith (anti-Sm), Ro/SSA, La/SSB, and U1 ribonucleoprotein (RNP)
  *Anti-double-stranded DNA (anti-dsDNA)
  *Antiphospholipid antibodies (lupus anticoagulant [LA], immunoglobulin [Ig] G and IgM anticardiolipin [aCL] antibodies, and IgG and IgM anti-beta2-glycoprotein [GP] 1)
  *C3 and C4 or CH50 complement levels
  *Erythrocyte sedimentation rate (ESR) and/or C-reactive protein (CRP) levels
  *Urine protein-to-creatinine ratio

==References include:==
https://www.nhs.uk/conditions/sjogrens-syndrome/\\ 
https://www.uptodate.com/contents/diagnosis-and-classification-of-sjogrens-syndrome\\