• Deepankar Raj Pathak, Ashish Kumar Chaurasiya, Rasish Subedi, Prabin Khatri, and Pooja Shah.
• Universal College of Medical Sciences, Bhairahawa, Rupandehi, Nepal.
• JNMA J Nepal Med Assoc. 2024 Jan 2; 62 (269): 495149-51.

UnlabelledSjogren's syndrome is a chronic multisystem autoimmune disease presenting a wide variety of clinical manifestations ranging from mild sicca symptoms to severe systemic symptoms involving pulmonary, renal, musculoskeletal, cutaneous, and haematological diseases. These symptomatic diversities can delay the correct diagnosis of Sjogren's Syndrome for a long time. Here, we report the case of a 59-year-old woman with fatigue and weakness in whom bicytopenia was documented. A thorough bicytopenia workup brought us to the final diagnosis of Sjogren's syndrome. Hydroxychloroquine was started which normalized the patient's blood parameters and clinical symptoms. The haematological alterations in Sjogren's syndrome are not pathognomonic. However, only bicytopenia can be the initial presentation of Sjogren's syndrome as in our patient. Therefore, inexplicable bicytopenia in a middle-aged female may alert the clinician about the possibility of Sjogren's syndrome.Keywordsautoimmune diseases; case reports; cytopenia; sjogren's syndrome.

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