Non-suppurative Destructive Cholangitis After Avacopan Therapy in Myeloperoxidase-Antineutrophil Cytoplasmic Antibody (MPO-ANCA)-Associated Glomerulonephritis: A Case Report and Review of the Literature. (PubMed, Cureus) - Sep 17, 2026 - "A 55-year-old obese female with myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA)-associated crescentic glomerulonephritis achieved remission via steroid pulse therapy, oral prednisolone (PSL), and rituximab. Seven weeks before admission, avacopan and ursodeoxycholic acid (UDCA) were initiated...To the best of our knowledge, this is the first report describing a comprehensive immunohistochemical evaluation of the periportal microenvironment in avacopan-induced biliary injury. This case highlights that severe cholangitis can occur regardless of baseline risk profiles or disease activity, underscoring the need for vigilant, long-term monitoring of liver enzymes and bilirubin levels during avacopan therapy."
Journal • Glomerulonephritis • Hepatology • Liver Failure • Lupus Nephritis • Nephrology • Obesity • CD4 • CD68 • CK19 • KRT19 • MPO
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Hiroshi Tominaga; Hisashi Hidaka; Kazuhiro Takeuchi; Keiya Nakamura; Kensuke Terakawa; Makoto Saegusa; Masataka Tochimoto; Rina Kamiya; Ryota Uchitsubo; Sayumi Kawamura; Shun Sakurabayashi; Tomomi Motohashi; Yasuo Takeuchi; Yuki Toyoda; Yukihiro Wada; Yutaro Saito
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