Download Citation on ResearchGate | Enfermedad de Buerger (tromboangeítis obliterante) | Thromboangiitis obliterans (TAO) is a segmental, inflammatory. Not to be confused with Berger’s disease (IgA nephropathy). Thromboangiitis obliterans, also known as Buerger disease is a recurring progressive inflammation. [ABSTRACT FROM AUTHOR]; Spanish: La tromboangitis obliterante ( enfermedad de Leo Buerger) es una enfermedad asociada con el consumo de tabaco.
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It is strongly associated with use of tobacco products,  primarily from smokingbut is also associated with smokeless tobacco. There is a recurrent acute and chronic inflammation and thrombosis of arteries and veins of the hands and feet. The main symptom is pain in the affected areas, at rest and while walking claudication.
Peripheral pulses are diminished or absent.
Thromboangiitis obliterans – Wikipedia
Fromboangeitis are color changes in the extremities. The colour may range from cyanotic blue to reddish blue. Skin becomes thin and shiny. Hair growth is reduced. Ulcerations and gangrene in the extremities are common complicationsoften resulting in the tromboangeitks for amputation of the involved extremity. There are characteristic pathologic findings of acute inflammation and thrombosis clotting of arteries and veins of the hands and feet the lower limbs being more common. The mechanisms underlying Buerger’s disease are still largely unknown, but smoking and tobacco consumption are major factors associated with it.
It has been suggested that the tobacco may trigger an immune response in susceptible persons or it may unmask a clotting defect, either of which could incite an inflammatory reaction of the vessel wall.
A possible role for Rickettsia in this disease has been proposed. A concrete diagnosis of thromboangiitis obliterans is often difficult as it relies heavily on exclusion of other conditions. The commonly followed diagnostic criteria are outlined below although the criteria tend to differ slightly from author to author.
Olin proposes the following criteria: Collateral circulation gives “tree root” or “spider leg” appearance. Distal plethysmography also yields useful information about circulatory status in digits. Skin biopsies of affected extremities are rarely performed because of the frequent concern that a biopsy site near an area poorly perfused with blood will not heal well. The cause of the disease is thought to be autoimmune in nature and heavily linked to tobacco use in patients with Buerger’s as primary disease.
Smoking cessation has been shown to slow the progression of the disease and decrease the severity of amputation in most patients, but does not halt the progression. In acute cases, drugs and procedures which cause vasodilation obliterannte effective in reducing pain experienced by patient. For example, prostaglandins like Limaprost  are vasodilators and give relief of pain, but do not help in changing the course of disease.
Epidural anesthesia and hyperbaric oxygen therapy also have vasodilator effect. In chronic cases, lumbar sympathectomy may be occasionally helpful.
It aids in healing and giving relief from pain of ischemic ulcers. Use of vascular growth factor and stem cell injections have been showing promise in clinical studies. Debridement is done in necrotic ulcers. In gangrenous digitsamputation is frequently required. Above-knee and below-knee amputation is rarely required. Streptokinase has been proposed as adjuvant therapy in some cases. Despite the clear presence of inflammation in this disorder, anti-inflammatory agents such as corticosteroids have not been shown to be beneficial in healing, but do have significant anti-inflammatory and pain relief qualities in low dosage intermittent form.
Similarly, strategies of anticoagulation have not proven effective. Buerger’s is not immediately fatal.
Prognosis markedly improves if a person quits smoking. Female patients tend to show much higher longevity rates than men. The only known way to slow the progression of the disease is to abstain from all tobacco products. Buerger’s is more common among men than women. Although present worldwide, it is more prevalent in the Middle East and Far East. Buerger’s disease was first reported by Felix von Winiwarter in in Austria.
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Both legs were affected, the right more seriously than the left. The King’s doctors prescribed complete rest and electric treatment to stimulate circulation, but as they were either unaware of the connection between the disease and smoking the King was a heavy smoker or unable to persuade the King to stop smoking, the disease failed to respond to their treatment.
The operation, as such, was successful, but the King was warned that it was a palliative, not a cure, and that there could be no assurance that the disease would not grow worse.
From all accounts, the King continued to smoke. The author and journalist John McBeth describes his experiences of the disease, and treatment for it, in a chapter called ‘Year of the Leg’ in his book entitled Reporter. Forty Years Covering Asia. From Wikipedia, the free encyclopedia. Ferri’s Clinical Advisor Instant Diagnosis and Treatment.
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N Engl J Med. Am J Med Sci. I may not last 6 years in office”. Retrieved December 17, Cardiovascular disease vessels I70—I99— Arteritis Aortitis Buerger’s disease.
Carotid artery stenosis Renal artery stenosis. Aortoiliac occlusive disease Degos disease Erythromelalgia Fibromuscular dysplasia Raynaud’s phenomenon. Arteriovenous fistula Arteriovenous malformation Telangiectasia Hereditary hemorrhagic telangiectasia. Cherry hemangioma Halo nevus Spider angioma. Chronic venous insufficiency Chronic cerebrospinal venous insufficiency Superior vena cava syndrome Inferior vena cava syndrome Venous ulcer.
Hypertensive heart disease Hypertensive emergency Hypertensive nephropathy Essential hypertension Secondary hypertension Renovascular hypertension Benign hypertension Pulmonary hypertension Systolic hypertension White coat hypertension.
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Complete occlusion buergwr the right and stenosis of the left femoral artery as seen in a case of thromboangiitis obliterans. D ICD – Inflammation Arteritis Aortitis Buerger’s disease. Hypertension Hypertensive heart disease Hypertensive emergency Hypertensive nephropathy Essential hypertension Secondary hypertension Renovascular hypertension Benign hypertension Pulmonary hypertension Systolic hypertension White coat hypertension.