Avacopan/cotrimoxazole: Drug induced liver injury and vanishing bile duct syndrome: case report.

A 70-year-old woman developed drug-induced liver injury (DILI) and vanishing bile duct syndrome (VBDS) while being treated with avacopan for microscopic polyangiitis (MPA) and cotrimoxazole to prevent pneumocystis pneumonia (PCP). She presented with jaundice, pale stools, and dark urine, and was admitted to the hospital due to acute liver dysfunction. Liver enzyme levels improved with treatment, but bilirubin levels continued to increase, leading to a diagnosis of DILI and VBDS attributed to avacopan and cotrimoxazole. Despite ongoing hepatoprotective therapy, the patient experienced complications such as severe hypercholesterolemia and PCP. [Extracted from the article]