Decline of Persistent Jaundice in a Patient With Autoimmune Hepatitis and Vanishing Bile Duct Syndrome Treated With Elobixibat for Constipation

We present the case of a 49-year-old woman with autoimmune hepatitis and persistent jaundice. On admission, pathology and laboratory results supported the diagnosis of autoimmune hepatitis-primary biliary cholangitis (AIH-PBC) overlap syndrome with vanishing bile duct syndrome (VBDS). Standard treatment, including methylprednisolone pulse therapy, prednisolone, azathioprine, bezafibrate, and ursodeoxycholic acid, failed to resolve jaundice. In addition to jaundice, the patient also had constipation and regularly used magnesium oxide and sennoside. Notably, the addition of elobixibat, initially prescribed for constipation, resulted in a marked improvement in jaundice. This case highlights the diagnostic and therapeutic challenges of AIH-PBC overlap syndrome with VBDS, particularly in cases of refractory jaundice. The observed efficacy of elobixibat suggests that it may be a valuable adjunctive therapy for severe cholestasis. Further research is warranted to clarify its therapeutic potential and underlying mechanisms in similar cases.