The Pathogenesis and Natural History of Sjogren's Disease

* INCLUSION CRITERIA: 1. Ability to sign informed consent form 2. Fulfilling one the definitions below: 1. Sjogren s defined by European-American (EA) classification criteria for primary or secondary Sjogren s Disease (SjD group) 2. Excluded from the EA criteria because of a comorbid condition but otherwise fulfilling the European-American classification criteria (EA excluded SjD group) 3. Incomplete SjD i. at least 2 of the EA criteria with a common manifestation of SjD not included in these criteria (e.g., fatigue, vasculitis, arthritis, etc) or ii. 2 or more common manifestations of SjD which are not included in the EA criteria (e.g.,: fatigue, vasculitis, arthritis, autonomic dysfunction, etc ) and are not explained by other conditions EXCLUSION CRITERIA: <!-- --> 1. Age \<16 years 2. inability or unwillingness to comply with follow up requirements 3. Any medical or psychological/psychiatric condition or treatment that, in the opinion of the Principal Investigator, would exclude the subjects from the research studies (e.g., alternative explanation for subjects signs and symptoms) 4. NIH employees who report directly to the principal investigator or who are a co-worker or relative of the principal investigator.