Life-threatening Haemoptysis in a patient with chronic Ulcerative Colitis

Anti-neutrophil cytoplasmic antibodies (ANCA) in the serum of patients with inflammatory bowel disease (IBD) are usually considered an ancillary finding of uncertain clinical significance. We report a patient with longstanding ulcerative colitis who presented with haemoptysis which became severe, concurrent with the worsening of the colitis. Imaging, absence of an alternative aetiology, and rapid response to high-dose methylprednisolone in the presence of p-ANCA suggested an IBD-related small vessel pulmonary vasculitis, a rare observation.