Tofacitinib Treatment for Primary Sjögren's Disease Complicated by Immune Thrombocytopenia: A Case Report

Primary Sjögren's disease (SjD) is a systemic autoimmune disorder that primarily affects the salivary and lacrimal glands. It has been associated with immune thrombocytopenia (ITP) in about 12% of cases. Current research into new treatment strategies for patients with SjD with ITP is limited. In this report, we present the case of a 38-year-old woman who has suffered from SjD and ITP for over 20 years. Despite undergoing treatment with prednisone, mycophenolate mofetil, rituximab, tacrolimus, and cyclosporine A, she has been unable to achieve a normalization of her platelet count. Eventually, tofacitinib was introduced into her treatment plan, which led to stable platelet counts and allowed for the complete discontinuation of prednisone. She has maintained this stability for more than 2 years so far. This case underscores the potential role of tofacitinib in managing SjD-ITP, particularly for patients who do not respond adequately or are intolerant to conventional immunosuppressive therapies.