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We report a case of a 78\u2010year\u2010old man with microscopic polyangiitis who developed rapidly progressive glomerulonephritis (RPGN) and vasculitis neuropathy. After developing RPGN, he was treated with prednisolone, which was ineffective. As the dosage of corticosteroids was decreased, he developed impaired dorsiflexion of the left ankle, tingling and numbness in his feet, consistent with vasculitis neuropathy. After a 3\u2010day administration of methylprednisolone, we started avacopan and prednisolone 20\u2009mg\/d to reduce the corticosteroid dosage. One week after starting avacopan, platelet counts began to decrease, eventually leading to the cessation of the drug. The possibility of thrombotic microangiopathy and heparin\u2010induced thrombocytopenia was considered unlikely given the clinical course and laboratory studies. After 3\u2009weeks of avacopan cessation, platelet counts began to increase, suggesting avacopan as the most probable cause of thrombocytopenia. Our case highlights the importance of postmarketing surveillance of avacopan to identify its adverse events that were not reported in clinical trials to ensure its safe use. Clinicians should carefully monitor platelet counts when using avacopan.<\/jats:p>","DOI":"10.1111\/1756-185x.14645","type":"journal-article","created":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T12:26:49Z","timestamp":1678192009000},"page":"1603-1607","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Thrombocytopenia during avacopan administration: A case report"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8330-002X","authenticated-orcid":false,"given":"Nobuhisa","family":"Morimoto","sequence":"first","affiliation":[{"name":"Department of Nephrology, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayasu","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Graduate School of Medical and Dental Sciences Tokyo Medical 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