From the Research
Gout can potentially elevate D-dimer levels, as evidenced by the most recent study in 2022 1, which suggests a link between gout disease activity and coagulation markers, including D-dimer. The relationship between gout and D-dimer levels is complex, with various studies indicating that acute gout flares can trigger activation of the coagulation system, leading to elevated D-dimer levels in some patients 2, 3, 1. This occurs due to inflammatory processes increasing fibrin formation and breakdown, which generates D-dimer. However, many other conditions can also cause D-dimer elevation, including infections, recent surgery, pregnancy, cancer, and other inflammatory disorders. Some studies have investigated the predictive value of plasma D-dimer in gout patients, with one study finding that D-dimer levels were significantly higher in patients with gout flare compared to those in remission 2. Another study found that plasma fibrinogen and D-dimer levels were increased in gout patients compared to healthy controls, and that these markers were positively correlated with gout disease activity 3. The most recent study in 2022 found that high disease activity was associated with higher levels of thrombin generation markers, including D-dimer 1. If you have gout and an elevated D-dimer, your healthcare provider should consider whether the elevation is due to the gout inflammation or if further evaluation is needed to rule out thrombotic conditions, especially if you have risk factors for blood clots. Key points to consider include:
- Gout can potentially elevate D-dimer levels due to inflammation and activation of the coagulation system.
- D-dimer elevation can also be caused by other conditions, and further evaluation may be needed to rule out thrombotic conditions.
- Management of gout with medications like colchicine, NSAIDs, or corticosteroids may help reduce inflammation and potentially normalize D-dimer levels if the elevation was related to the gout flare. It is essential to note that the evidence is not very strong, and the relationship between gout and D-dimer levels is still being researched. Therefore, a firm decision on the side of caution is necessary in real-life clinical medicine, prioritizing the patient's morbidity, mortality, and quality of life. In clinical practice, the management of gout should focus on reducing inflammation and preventing further flares, while also monitoring for potential thrombotic complications. Overall, the current evidence suggests that gout can potentially elevate D-dimer levels, and healthcare providers should be aware of this relationship when managing patients with gout.