Edoxaban-Induced Vanishing Bile Duct Syndrome: A Case Report With Review of the Literature.

Edoxaban is an oral, highly selective, direct factor X-inhibitor approved by the European Medical Agency for the prevention of stroke in non-valvular atrial fibrillation. Edoxaban is contraindicated in patients with severe hepatic insufficiency and, among adverse effects, serum bilirubin level and gamma-glutamyl transpeptidase elevation are described as common events. We report the case of an 82-year-old man with hepatocellular carcinoma who developed a fatal vanishing bile duct syndrome (VBDS) a few weeks after the administration of edoxaban for non-valvular atrial fibrillation. To the best of our knowledge, this is the first report to describe a case of acute VBDS possibly related to edoxaban.