Why do u think my md still suspects sjogrens vs lupus(ana 1:640, negative lip biopsy, raynauds, fatigue, photosens, rashes, jt/muscle pain, sicca ?

The clinical picture: It is often difficult to determine whether sjogrens is a primary diagnosis or secondary to other connective tissue disorders such as lupus. . The lip biopsy is not foolproof but if salivary glands present were all normal then i would suspect that lupus was primary and the sjogrens was secondary.

Undifferentiated CTD: Clinical presenation can be classified as an undifferentiated connective tissue disease (uctd). Likely not primary sjogren's since lip biopsy (usually gold standard for diagnosis of sjogren's) was negative. Would recommend additional evaluation including specific antibodies such as dsdna and ena. Also would recommend rheumatology consult.