title: A sudden onset of diabetic ketoacidosis and acute pancreatitis after introduction of mizoribine therapy in a patient with rheumatoid arthritis.
abstract: Mizoribine has been recognized to have an acceptable toxicity profile compared with other immunosuppressants. In this study, however, we report a case of diabetic ketoacidosis and acute pancreatitis that suddenly occurred in a rheumatoid arthritis patient 2 weeks after introduction of mizoribine therapy. To the best of our knowledge, this is the first case in the literature to show mizoribine-induced diabetic ketoacidosis. Through prompt diagnosis and treatment, the patient recovered from these extremely rare but potentially lethal complications.
authors.affiliation: Clinical Research Center for Rheumatic Disease and Department of Rheumatology, Kumamoto Saishunsou National Hospital, 2659 Suya, Kohshi, Kumamoto, 861-1196, Japan. moris@saisyunsou1.hosp.go.jp
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Mori
authors.forename: Kenji
authors.initials: K
authors.lastname: Ebihara
mesh_terms: D000208:Acute Disease; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D001550:Benzamidines; D016883:Diabetic Ketoacidosis / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use; D006146:Guanidines / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D010195:Pancreatitis / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use; D011480:Protease Inhibitors / Q000627:therapeutic use; D012263:Ribonucleosides / Q000009:adverse effects*; D016896:Treatment Outcome; D028761:Withholding Treatment
chemical_list: D001550:Benzamidines; D005938:Glucocorticoids; D006146:Guanidines; D007004:Hypoglycemic Agents; D007166:Immunosuppressive Agents; D007328:Insulin; D011480:Protease Inhibitors; D012263:Ribonucleosides; C010052:mizoribine; D011239:Prednisolone; C032855:nafamostat