INTRODUCTION
Primary Sjogren’s syndrome (SS) is a chronic autoimmune disease, characterized by lymphocytic infiltration and destruction of exocrine glands, especially the salivary and lacrimal glands along with occasional extra glandular involvement. 2 The hallmark of the disease is exocrinopathy, which often results in dryness of the mouth and eyes, fatigue, and joint pain. Although extra glandular manifestations are uncommon, they can occur with musculoskeletal, renal, pulmonary, and hematological diseases. The prevalence of primary SS is found to be 6.92 per 100,000 person-years.11 It is more predominant in females than males (female-to-male ratio = 9:1.3). Primary SS should be considered in the differential diagnosis of apparently ‘idiopathic’ cytopenia and actively sought by directed history, Schirmer’s test, and autoantibody screening.1Cytopenia is considered rare in primary SS, with only a limited number of cases documented in the existing literature.4 We report the case of a 60-year-old woman who presented with persistent unexplained bicytopenia (anemia and thrombocytopenia) and was later diagnosed as SS after comprehensive investigations.