Vanished Without a Trace: A Middle-Aged Man With Vanishing Bile Duct Syndrome-A Case Report.

Vanishing bile duct syndrome, VBDS, is a rare disease that is poorly understood and is a term used to loosely describe a group of disorders associated with the progressive destruction of intrahepatic ducts. This syndrome ultimately leads to cholestasis. There are many potential etiologies for this disease including primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), autoimmune diseases, medications, genetic abnormalities, infectious causes, or neoplastic disorders. The diagnosis consists of both clinical and histological findings found via liver biopsy. We present a rare case of VBDS in a 41-year-old male likely attributed to multiple herbal supplements in the setting of severe hyperlipidemia. This case highlights the importance of recognizing supplement-related liver injury and unusual metabolic associations.