Buerger disease, a nonatherosclerotic vascular disease also known as thromboangiitis obliterans (TAO), is characterized by the absence or minimal presence of atheromas, segmental vascular inflammation, vasoocclusive phenomenon, and involvement of small- and medium-sized arteries and veins of the upper and lower extremities. The condition is strongly associated with heavy tobacco use, and progression of the disease is closely linked to continued use. The typical presentations are rest pain, unremitting ischemic ulcerations, and gangrene of the digits of hands and feet, and as the disease evolves, the patients may require several surgical amputations.
The first reported case of thromboangiitis obliterans was described in Germany by von Winiwarter in an 1879 article titled ?A strange form of endarteritis and endophlebitis with gangrene of the feet.??A little more than a quarter of a century later, in Brookline, NY, Leo Buerger published a detailed description of the disease in which he referred to the clinical presentation of thromboangiitis obliterans as ?presenile spontaneous gangrene.??The paper discussed the pathological findings in 11 limbs amputated from Jewish patients with the disease.\
Buerger?s disease symptoms include:
- Pain that may come and go in your legs and feet or your arms and hands. This pain typically occurs when you use your hands or feet and eases when you stop activity (claudication).
- Inflammation along a vein just below the skin?s surface (due to a blood clot in the vein).
- Fingers and toes that turn pale when exposed to cold (Raynaud?s phenomenon).
- Painful open sores on your fingers and toes.
Tobacco use
Cigarette smoking greatly increases your risk of Buerger?s disease. Heavy cigarette smokers (people who smoke one and a half packs a day or more) are most likely to develop Buerger?s disease, though it can occur in people who use any form of tobacco, including cigars and chewing tobacco. People who smoke hand-rolled cigarettes using raw tobacco may have the greatest risk of Buerger?s disease.
It isn?t clear how tobacco use increases your risk of Buerger?s disease, but virtually everyone diagnosed with Buerger?s disease uses tobacco. It?s thought that chemicals in tobacco may irritate the lining of your blood vessels, causing them to swell. Rates of Buerger?s disease are highest in areas of the Middle East and Far East where heavy smoking is most common.
Although secondhand smoke isn?t thought to be a major risk factor for Buerger?s disease, if you?re diagnosed, you should stay away from people who are smoking. Secondhand smoke could worsen your condition.
Chronic gum disease
Long-term infection of the gums is also associated with the development of Buerger?s disease.
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