61- year-old female school teacher, experiencing pain and early morning stiffness for the past 6 years

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The 61-year-old, female patient had a long-standing RA of 6 years duration and was on alternative therapy for the past 5 years and intermittent NSAIDs. She had severe dry mouth/eyes, significant weight loss, reduced appetite, and back pain. The patient was immobile with minimal swelling and pain. Can you find out what the case’s final diagnosis is?