In addition to sicca symptoms, Sjögren's disease also includes non-glandular manifestations such as dysautonomia and small fiber neuropathy. These manifestations are often difficult to assess and manage. Information about them was presented at this year's American College of Rheumatology conference. In addition to dry eyes and mouth, joint inflammation, rashes, enlarged lymph nodes, and peripheral nerve involvement also occur. Systemic manifestations include musculoskeletal symptoms such as arthralgias and myalgias in 60-70% of cases, cutaneous manifestations in 5-10%, pulmonary in 10-20% and gastrointestinal in 25-60%. Neurological manifestations include peripheral and central neuropathy. Patients have a higher risk of developing lymphomas.