Case report of DKA from a gout flare

A case published by Annals of Internal Medicine: Clinical Cases on Aug. 6 described the rare situation of diabetic ketoacidosis (DKA) during a severe acute polyarticular gout flare. A 46-year-old man with a history of tophaceous gout, managed only with colchicine and NSAIDs as needed, and no diabetes presented to the ED with polyuria, polydipsia, and joint pain with swelling in his knees two to three days before admission. The patient was admitted to the ICU for DKA and eventually treated successfully with anakinra, an interleukin-1 receptor antagonist.