Severe Thrombocytopenia as an Early Manifestation in a Young Female with Sjögren's Syndrome.

Thrombocytopenia is defined as a reduction in circulating platelet count below 1.5 L/µL, resulting from reduced platelet production or increased destruction secondary to infections, drugs, immune mechanisms, or systemic diseases. In this case, we report a 20-year-old young Indian female presenting with fever, fatigue, and bilateral parotid swelling with severe thrombocytopenia. Laboratory investigations revealed mild anemia, weakly positive antinuclear antibody, reduced salivary flow rate, and minor salivary gland biopsy showing focal lymphocytic sialadenitis, suggesting Sjögren's syndrome with secondary immune thrombocytopenia (ITP). The patient was started on oral steroids, and there was significant clinical improvement and improvement in thrombocytopenia. This case emphasizes the importance of evaluating autoimmune causes in unexplained thrombocytopenia in young patients and not ruling them out as a viral etiology.