Acute Necrotizing Pancreatitis Secondary to Acute Intermittent Porphyria: A Rare Clinical Association.

We report a rare case of acute necrotizing pancreatitis in a 23-year-old man during an acute attack of acute intermittent porphyria (AIP). Initially presenting with neurovisceral symptoms and hyponatremia, he was diagnosed with AIP based on clinical features and a positive urine porphobilinogen test. Despite symptomatic improvement, he developed severe abdominal pain and elevated pancreatic enzymes, with imaging confirming necrotizing pancreatitis. He required prolonged supportive care, percutaneous drainage, and nutritional support. This case highlights the importance of recognizing pancreatic complications in AIP, as timely diagnosis and multidisciplinary management are crucial for favorable outcomes in this rare but serious association.