{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:13:03Z","timestamp":1789560783299,"version":"build-2803163510"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 2","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Thrombocytopenia is defined as a reduction in circulating platelet count below 1.5 L\/\u00b5L, 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 Sj\u00f6gren\u2019s 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.<\/jats:p>","DOI":"10.4103\/aam.aam_759_25","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T07:04:04Z","timestamp":1775545444000},"page":"S337-S339","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Severe Thrombocytopenia as an Early Manifestation in a Young Female with Sj\u00f6gren\u2019s Syndrome"],"prefix":"10.4103","volume":"25","author":[{"given":"Madhulika L.","family":"Mahashabde","sequence":"first","affiliation":[{"name":"Department of General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brugumalla V. Nitendra","family":"Saketh","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav A.","family":"Chaudhary","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanee Rajesh","family":"Meghrajani","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"R2-20260916","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1056\/NEJMcp1810479","article-title":"Immune thrombocytopenia","volume":"381","author":"Cooper","year":"2019","journal-title":"N Engl J Med"},{"key":"R3-20260916","doi-asserted-by":"crossref","first-page":"191","DOI":"10.7150\/ijms.17718","article-title":"Reviewing primary Sj\u00f6gren's syndrome: Beyond the dryness \u2013 From pathophysiology to diagnosis and treatment","volume":"14","author":"Both","year":"2017","journal-title":"Int J Med Sci"},{"key":"R4-20260916","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1136\/bmj.284.6331.1738","article-title":"Predictive value of SS-B precipitating antibodies in Sjo\u00f6gren's syndrome","volume":"284","author":"Isenberg","year":"1982","journal-title":"Br Med J (Clin Res Ed)"},{"key":"R5-20260916","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1002\/art.39859","article-title":"2016 American College of Rheumatology\/European League Against Rheumatism classification criteria for primary Sj\u00f6gren's syndrome: A consensus and data-driven methodology involving three international patient cohorts","volume":"69","author":"Shiboski","year":"2017","journal-title":"Arthritis Rheumatol"},{"key":"R6-20260916","first-page":"e5908","article-title":"Clinical characteristics of immune thrombocytopenia associated with autoimmune disease: A retrospective study","volume":"96","author":"Chen","year":"2017","journal-title":"Medicine (Baltimore)"},{"key":"R7-20260916","first-page":"196","article-title":"Clinical characteristics of secondary immune thrombocytopenia associated with primary Sj\u00f6gren's syndrome","volume":"7","author":"Li","year":"2020","journal-title":"Front Med (Lausanne)"},{"key":"R8-20260916","first-page":"152251","article-title":"Characteristics and treatment responses of immune thrombocytopenia in patients with primary Sj\u00f6gren syndrome","volume":"62","author":"Xu","year":"2023","journal-title":"Semin Arthritis Rheum"},{"issue":"Suppl 2","key":"R9-20260916","doi-asserted-by":"crossref","first-page":"kead104.207","DOI":"10.1093\/rheumatology\/kead104.207","article-title":"P166 parotid benign lymphoepithelial cyst in connective tissue disease: A rare case series and literature review","volume":"62","author":"Palaniappan","year":"2023","journal-title":"Rheumatology"},{"key":"R10-20260916","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1038\/ncprheum0799","article-title":"A case of undifferentiated connective tissue disease: Is it a distinct clinical entity?","volume":"4","author":"Mosca","year":"2008","journal-title":"Nat Clin Pract Rheumatol"},{"key":"R11-20260916","first-page":"65","article-title":"A case of treatment with steroid and hydrochloroquine in a patient with thrombocytopenia associated with primary Sj\u00f6gren's syndrome","volume":"36","author":"Park","year":"2017","journal-title":"Keimyung Med J"}],"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_759_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:00:55Z","timestamp":1789560055000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_759_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":10,"journal-issue":{"issue":"Suppl 2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/aam.aam_759_25","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]},"assertion":[{"value":"2025-11-23","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-06","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}