Introduction:
Antiphospholipid syndrome (APS), or antiphospholipid antibody syndrome, is an autoimmune, hypercoagulable condition caused by antiphospholipid antibodies.

Aim:
This case study aims to highlight diagnostic challenge of APS and its association with sicca syndrome.

Case study:
Our case is a female patient who was transferred to Rheumatology Clinic from the Central Intensive Care Unit (CICU) after being unconscious and on assisted breathing for 5 days. In 2006, she suffered a miscarriage and pulmonary thromboembolism. Since then, she has been under anticoagulant treatment. Clinical observation and positivity of laboratory tests such as anti Ro SSA, anti La SSB and Schrimer test confirmed us sicca syndrome. Positivity of lupus anticoagulant, anti-cardiolipin and anti-B2GP1 raise us suspicious about APS. The patient stayed in our clinic for approximately 10 days and based on the anamnesis, objective examination, laboratory and imaging tests, she was discharged home with the diagnosis of APS accompanied by sicca syndrome.

Results and discussion:
APS is an autoimmune condition, often challenging to diagnose, especially when it occurs in patients without sufficient symptoms and signs and without positivity in blood tests. The diagnosis of APS is often made through a combination of symptoms and laboratory tests.

Conclusions:
Diagnosing APS is not always easy, it is quite complex. Any case associated with spontaneous abortion and vascular accidents, without risk factors, should be suspected and investigated for APS. APS can often be secondary associated with other autoimmune diseases. Most often APS is associated with systemic lupus erythematosus, but in our case it is associated with sicca syndrome.