Avacopan Causing Vanishing Bile Duct Syndrome in an Adult Patient With Microscopic Polyangiitis
Microscopic polyangiitis (MPA) is a systemic necrotizing small-vessel vasculitis that may affect multiple organs. Avacopan, an oral complement (C5a) receptor inhibitor, was recently approved and recommended as a glucocorticoid-sparing induction therapy for severe granulomatosis with polyangiitis and...
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| Format: | Article |
| Language: | English |
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American College of Physicians
2024-11-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2024.0602 |
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| author | Alexander Tang David M.P. Di Fonzo Saba Alsaddah Chelsea Maedler-Kron Arielle Mendel Giada Sebastiani |
| author_facet | Alexander Tang David M.P. Di Fonzo Saba Alsaddah Chelsea Maedler-Kron Arielle Mendel Giada Sebastiani |
| author_sort | Alexander Tang |
| collection | DOAJ |
| description | Microscopic polyangiitis (MPA) is a systemic necrotizing small-vessel vasculitis that may affect multiple organs. Avacopan, an oral complement (C5a) receptor inhibitor, was recently approved and recommended as a glucocorticoid-sparing induction therapy for severe granulomatosis with polyangiitis and MPA. We present a case of a 74-year-old patient with MPA who was treated with avacopan and who developed a severe cholestatic liver injury. A liver biopsy showed histologic evidence of vanishing bile duct syndrome. This case highlights the importance of considering vanishing bile duct syndrome in patients who take avacopan. In this clinical context, prompt recognition and discontinuation of avacopan is essential to avoid worsening liver injury. |
| format | Article |
| id | doaj-art-404841c8ed5a4ca082e3816bac96b2ce |
| institution | OA Journals |
| issn | 2767-7664 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | American College of Physicians |
| record_format | Article |
| series | Annals of Internal Medicine: Clinical Cases |
| spelling | doaj-art-404841c8ed5a4ca082e3816bac96b2ce2025-08-20T02:27:45ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642024-11-0131110.7326/aimcc.2024.0602Avacopan Causing Vanishing Bile Duct Syndrome in an Adult Patient With Microscopic PolyangiitisAlexander Tang0David M.P. Di Fonzo1Saba Alsaddah2Chelsea Maedler-Kron3Arielle Mendel4Giada Sebastiani51Division of General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada1Division of General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada2Department of Clinical Laboratory Medicine, Division of Pathology McGill University Health Centre, Montreal, Quebec, Canada2Department of Clinical Laboratory Medicine, Division of Pathology McGill University Health Centre, Montreal, Quebec, Canada3Division of Rheumatology, McGill University Health Centre, Montreal, Quebec, Canada5Research Director Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, CanadaMicroscopic polyangiitis (MPA) is a systemic necrotizing small-vessel vasculitis that may affect multiple organs. Avacopan, an oral complement (C5a) receptor inhibitor, was recently approved and recommended as a glucocorticoid-sparing induction therapy for severe granulomatosis with polyangiitis and MPA. We present a case of a 74-year-old patient with MPA who was treated with avacopan and who developed a severe cholestatic liver injury. A liver biopsy showed histologic evidence of vanishing bile duct syndrome. This case highlights the importance of considering vanishing bile duct syndrome in patients who take avacopan. In this clinical context, prompt recognition and discontinuation of avacopan is essential to avoid worsening liver injury.https://www.acpjournals.org/doi/10.7326/aimcc.2024.0602 |
| spellingShingle | Alexander Tang David M.P. Di Fonzo Saba Alsaddah Chelsea Maedler-Kron Arielle Mendel Giada Sebastiani Avacopan Causing Vanishing Bile Duct Syndrome in an Adult Patient With Microscopic Polyangiitis Annals of Internal Medicine: Clinical Cases |
| title | Avacopan Causing Vanishing Bile Duct Syndrome in an Adult Patient With Microscopic Polyangiitis |
| title_full | Avacopan Causing Vanishing Bile Duct Syndrome in an Adult Patient With Microscopic Polyangiitis |
| title_fullStr | Avacopan Causing Vanishing Bile Duct Syndrome in an Adult Patient With Microscopic Polyangiitis |
| title_full_unstemmed | Avacopan Causing Vanishing Bile Duct Syndrome in an Adult Patient With Microscopic Polyangiitis |
| title_short | Avacopan Causing Vanishing Bile Duct Syndrome in an Adult Patient With Microscopic Polyangiitis |
| title_sort | avacopan causing vanishing bile duct syndrome in an adult patient with microscopic polyangiitis |
| url | https://www.acpjournals.org/doi/10.7326/aimcc.2024.0602 |
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