Background: Although systemic inflammatory polyarticular gout syndrome (SIPGS) occurs in clinical practice, only few case reports have yet been published. Materials and Methods: Retrospective analysis of all consecutive patients between January 2013 and April 2015 with SIPGS, defined by involvement of ? 5 joint regions, C-reactive protein (CRP) ? 80 mg/l and/or erythrocyte sedimentation rate (ESR) ? 80 mm/h, and of age-and gender-matched low-grade inflammatory gout (LIG) patients, with CRP ? 80mg/L and ESR ? 80mm/h and with at least one joint involved. Results: Twenty-two of 152 gout patients fulfilled the SIPGS inclusion criteria; 22 age- and gender matched LIG patients were identified. Mean CRP was 172 mg/l (SD ± 84) and 25 mg/l (SD ± 21); mean ESR was 91 mm/h (SD ± 24) and 50 mm/h (SD ± 27) in SIPGS and LIG patients. All SIPGS, but only 12 LIG patients had anemia. Procalciton was always negative. A mean of 10 and 4 joint regions were affected in SIPG and LIG, respectively. All SIPGS patients showed bilateral arthritis, while only 11 LIG patients had bilateral MTP I joint involvement. The interval between symptom onset and admission was 11 and 20 days; while inpatient treatment was 14 and 9.5 days in SIPGS and LIG, respectively. Acute renal failure was common in SIPGS (N=8 vs.1). Non-steroidal antirheumatic drugs (NSAIDs) had to be replaced in all SIGPS patients. Conclusion: SIPGS patients have bilateral joint involvement and rarely fever. Anemia is common. Normal procalcitonin helps differentiating SIPGS from sepsis. SIPGS may be complicated by renal failure. NSAIDs are ineffective