We report the case of a 68-year-old man who presented with pleural effusion and dyspnea during treatment for alcoholic liver cirrhosis. The pleural effusion was transudative and it was diagnosed to be hepatic pleural effusion. Thoracic drainage was continued, but the amount of pleural fluid drainage did not decrease. The patient was strongly positive for antinuclear antibodies and anti-SS-A and anti-SS-B antibodies, thus leading us to suspect pleurisy caused by Sjögren's syndrome. Steroid administration decreased pleural drainage; however, cirrhosis progressed and the patient eventually died. An autopsy revealed pleurisy. Other causes may also be involved in treatment-resistant hepatic effusion.
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