Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 11 1 2026 08 03 15 20 EN Mohak Jain Department of General Medicine, Baroda Medical College, Vadodara, Gujarat, India. Yash Patel Department of General Medicine, Baroda Medical College, Vadodara, Gujarat, India. Ajay Parmar Department of General Medicine, Baroda Medical College, Vadodara, Gujarat, India. 2025 12 16 2026 05 09 We report a rare case of polyautoimmunity in a 40-year-old male presenting with massive pericardial effusion, severe primary hypothyroidism, primary Sjögren’s syndrome (SS), and leukocytoclastic vasculitis. While hypothyroidism and SS are predominantly female disorders, their confluence in a male patient presents unique diagnostic challenges. The patient exhibited progressive dyspnoea, generalized weakness, xerosis, and purpuric rashes. Diagnostic workup revealed massive pericardial effusion requiring pericardiocentesis, TSH >100 mIU/L, and positive antiSSA/Ro and anti-SSB/La antibodies. He was treated with levothyroxine, corticosteroids, and supportive care, resulting in the resolution of the effusion, vasculitic lesions, and renal impairment. This case highlights the importance of screening for multiple autoimmune pathologies in patients presenting with complex, multisystemic illness to ensure timely and appropriate multidisciplinary management. https://crcp.tums.ac.ir/index.php/crcp/article/view/1153 https://crcp.tums.ac.ir/index.php/crcp/article/download/1153/770