Anti-neutrophil cytoplasmic antibody-associated vasculitis presenting with acute pancreatitis, jaundice, severe anaemia and upper gastrointestinal bleed

Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) presenting with predominant gastrointestinal (GI) symptoms in the absence of overt respiratory or renal involvement is rare. We present a young man with recurrent ocular and oral symptoms who presented to us in the second week of moderately severe acute pancreatitis (AP) with upper GI bleeding and was diagnosed with probable AAV based on serology and biopsy findings after excluding alternative diagnoses. He responded well to immunosuppressive therapy with resolution of AP and GI bleed. This case highlights the necessity of a high index of suspicion for vasculitis in unexplained AP and/or GI bleed and actively pursuing it by serology and biopsy to improve outcomes.