Patient case (clinical description): A 40-year-old woman comes to the clinic complaining of gritty sensation in her eyes. She also has difficulty swallowing dry foods with no pain or heartburn.  The patient is a schoolteacher and must drink water frequently during lectures due to her mouth dryness.  She also reports occasional joint pain.  Medical history is not significant other than the confirmed Sjogren disease with no other rheumatologic disease.  She is sexually active with her husband and has 2 children both delivered by natural vaginal delivery. She has no history of any kind of surgery. Physical examination shows conjunctival erythema and cracking of the lips. The remainder of the examination and history is normal. Her lab result shows elevated ESR (50 mm/h)

Patient's own account: I went to the clinic because I had a terrible gritty sensation in my eyes. It was also hard to swallow dry food, but it didn't burn, and there was no pain. I'm a 40-year-old female school teacher and I should drink water for the lectures because otherwise, my mouth gets really dry. I also have joint pain from time to time. I have been diagnosed with Sjogren disease but no other rheumatologic disease. I have a husband, we're sexually active, and I also have two lovely children that I delivered both naturally. I never undergone any surgery. Physical examination when I came to the clinic, and it showed cracking on my lips and a pink eye. The rest was fine. I also did some lab tests, and they came back with high ESR.

Clinical trial: Sjogren's Lung Study

Eligibility criteria:
Inclusion Criteria:

        Group 1: Interstitial Lung Disease and Other Parenchymal Lung Diseases

          -  Known or suspected interstitial lung disease regardless of radiographic pattern

          -  Interstitial lung disease due to alternative autoimmune etiology

          -  Sarcoidosis

          -  Organizing pneumonia

          -  Hypersensitivity pneumonitis absent known or suspected trigger

          -  Primary pulmonary lymphoma

          -  Other idiopathic pulmonary conditions at discretion of study team

        Group 2: Refractory Airway Symptoms

          -  Chronic cough despite treatment trials with albuterol, proton-pump inhibitors and
             anti-histamine and intranasal corticosteroids

          -  Persistent bronchial hyperreactivity (defined as positive response to methacholine
             challenge on spirometry or subjective worsening after exposure to airway irritants
             such as tobacco, pollution, etc) or persistent asthma symptoms despite trial of
             inhaled corticosteroid and long acting bronchodilator

          -  Unexplained persistent bronchial wall thickening on CT imaging

          -  Recurrent or chronic bronchiolitis (including but not limited to chronic
             bronchiolitis, obliterative bronchiolitis, lymphocytic bronchiolitis, constrictive
             bronchiolitis associated with bronchiolar destruction, and panbronchiolitis)

          -  Bronchiectasis

          -  Lymphocytic alveolitis on bronchoalveolar lavage absent hypersensitivity pneumonitis
             with known trigger or HIV

          -  Recurrent bacterial pneumonia (greater than 2 episodes in 1 year, confirmed by focal
             consolidative opacity on chest imaging and requiring antibiotic therapy)

        Group 3: Other

        •Select patients outside the protocol testing schema who have one of the above lung
        diseases and are found to have Sjogren's syndrome through the course of their normal
        clinical care will be invited to participate in the data collection portion of the study
        for analyzing longitudinal outcomes.

        Exclusion Criteria:

          -  Patients with interstitial lung disease due to a known or suspected trigger such as
             drug-induced (including but not limited to nitrofurantoin, amiodarone, methotrexate
             and other chemotherapies), inorganic dust exposure (including but not limited to
             asbestos, silica, hard metals, coal dust) or organic exposure (including but not
             limited to birds, hay, mold).

          -  Patients who have taken a muscarinic antagonist or agonists within 7 days of planned
             testing

          -  Patients who are unable to consent for themselves
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.


Eligibility (NLI label): Contradiction