Reduced function of exocrine glands is usually first manifested as dryness of the eyes (keratoconjunctivitis sicca) and mouth (xerostomia). May occur as a primary disease or secondary to rheumatoid arthritis, or rarely to SLE or scleroderma. 10–15% of patients with rheumatoid arthritis suffer from sicca symptoms. Presence of autoantibodies is typical in Sjögren's syndrome. Their absence in patients suffering from dryness of the eyes and mouth speaks against the diagnosis.