Primary Sjogren Syndrome is one of the most common auto immunedisease with a prevalence rate ranging between .06% and 1.5%. Sjogren syndrome occurs mainly due to loss of immunological tolerance to self-antigens leading to autoimmune destruction of mainly salivary and lacrimal glands. Soxerostomia and xerophthalmia are the predominant features of the disease. Extra-glandular manifestations such as fatigue, arthralgia, peripheral neuropathy, purpurea, pulmonary infiltrates are also not so uncommon. Here we want to discuss a case of 33 years old lady presented to the clinic with repeated (4 episodes) episodes of hepatitis in last 6 and ½ years without predominant features of dry eyes and dry mouth. After thorough clinical and investigational workup, we have found out that recurrent hepatitis is due to acute exacerbation of autoimmune hepatitis and Sjogren syndrome is the underlying disease. In this report, we are going to present unusual presentation of this relatively common rheumatological disorder, Sjogren and difficulties facing diagnosis of Autoimmune hepatitis in the setting of concomitant rheumatological disorder.
