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.
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