THROMBOANGIITIS OBLITERANS

By Gary M. White, MD


Thromboangiitis obliterans, aka Buerger's disease, is a rare disease of the arteries and veins in the arms and legs.

Clinical

Claudication, pain at rest, disturbed sensory function, decreased pulses and necrosis or ulceration of the digits, especially the toes in a young, male smoker is characteristic. Reversible Raynaud's phenomenon may occur. Those who continue to use tobacco may suffer from digital gangrene and subsequent amputation. This entity also known as Buerger's disease is a nonatherosclerotic, occlusive process of small and medium arteries and veins. Only rarely are the viscera or large arteries affected.

Work up

Referral to a vascular surgeon is in order. Blood workup to include an ANA and ANCA should be done, in particular to exclude scleroderma.

Treatment

Smoking must be stopped immediately. This greatly reduces the future likelihood of amputation. Other therapeutic interventions are supportive and include local wound care, pentoxifylline, antibiotics, NSAID and amputation.

References

Exp Ther Med. 2013 Aug; 6(2): 317–320.

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