Introduction
Primary Sjogren’s syndrome (SS) is a systemic autoimmune disorder commonly characterized by dryness of the eyes and mouth due to inflammation and subsequent pathology of the lacrimal and salivary glands. The hallmark feature of SS is exocrinopathy, which frequently results in xerostomia and keratoconjunctivitis sicca, accompanied by fatigue and joint pain. Although extra-glandular manifestations are rare, they can affect musculoskeletal, renal, pulmonary, and hematological systems. SS should be considered in the differential diagnosis of idiopathic cytopenia and actively investigated through patient history, Schirmer’s test, and autoantibody screening. Cytopenia in primary SS is uncommon, with few cases reported in the literature. Here, we present the case of a 60-year-old woman with persistent unexplained bicytopenia (anemia and thrombocytopenia). After a comprehensive evaluation, she was diagnosed with SS.