Sjogrens is a lot more then dryness, it can attack glands, joints, liver, kidney, it can cause GI issues. migraines, sinus infections, TMJ, the list goes on and on. Severe fatigue too. So my fatigue is really bad because of the LGL and the Sjogrens together. My Rheumy and my hemotology/oncologist work together on this. There is new research in Europe connecting the two illnesses. So far no MTX for me yet, just Plaquenil.