Deep Vein Thrombosis-Induced Systemic Inflammation Triggering an Acute Polyarticular Gout Flare: A Case Report

TL;DR

A man with gout developed a severe gout flare after a deep vein thrombosis, suggesting a link between blood clots and inflammation.

Contribution

This case report highlights a novel connection between deep vein thrombosis and acute gout flares through systemic inflammation.

Findings

A DVT was followed by a severe polyarticular gout flare in a patient with a history of gout.

Systemic inflammation markers were significantly elevated during the gout flare.

Thromboinflammatory processes may trigger gout attacks even without high uric acid levels.

Abstract

Deep vein thrombosis (DVT) and gout are traditionally regarded as distinct conditions, yet emerging evidence suggests important inflammatory and clinical connections. We present a 40-year-old man with a history of crystal-proven gout who developed a left gastrocnemius DVT after prolonged travel, followed shortly by a severe polyarticular gout flare. Laboratory studies revealed marked hyperinflammation (C-reactive protein peaking at 87.8 mg/L) and a new positive antinuclear antibody titer (1:320, homogeneous). Arthrocentesis confirmed monosodium urate crystals, while magnetic resonance imaging demonstrated synovitis, a cartilaginous loose body, and degenerative changes. Coordinated care among hematology, rheumatology, and orthopedics involved anticoagulation management, intra-articular corticosteroid injection, and tailored anti-inflammatory therapy. This case illustrates how thromboinflammatory cytokines and oxidative stress accompanying DVT may precipitate acute gout, even in the absence of marked hyperuricemia. Recognizing this interplay is essential for timely diagnosis, safe therapeutic decision-making in the setting of anticoagulation, and ongoing surveillance for autoimmune disease.

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