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| Disease found: | Buerger's Disease |
| Current as of: | October 8, 2024 |
| Disease Overview: | Mostly seen in young-to-middle-aged male smokers; causes narrowing and occlusion of veins and arteries in extremities; cause and mechanism is largely unknown but many believe tobacco is required to trigger disease [more info] |
| Signs and Symptoms: | Extreme arm and leg pain at rest as well as claudication; may get limb ulceration, Raynaud's phenomenon, thrombophlebitis. Risk of ulcers progressing to gangrene at fingertips and toes. [more info] |
| Diagnosis: | Clinical diagnosis; there is no specific test. Lab tests, angiography can help to exclude other causes of peripheral vascular disease. Some recommend looking for 5 key symptoms: smoking, age <50, infrapopliteal artery involvement, upper limb involvement or migratory phlebitis, absence of atherosclerosis; necessity of all 5 criteria is debated [more info] |
| Treatment: | Smoking cessation often leads to resolution of symptoms and is the only definitive treatment. Medications which may help more severe cases include anticoagulants, anti-inflammatory drugs, vasodilators. [more info] Therapeutic angiogenesis revascularization therapies are a recent idea of study. [more info] |
| Clinical Management: | In severe cases (more common if patient does not stop smoking), bypass surgery, sympathectomy, though with mixed clinical results. Amputation may become necessay to address severe and persistent disease. [more info] |
| Referral: | Patients should be referred to rheumatology. The Vasculitis Foundation maintains a database of nationwide and international rheumatology clinics.Referral to Medical Genetics Department, if available. Initial virtual care is also available through organizations like TeleRare Health. |
| Clinical Trials: | Currently, no US trials are recruiting; a small number of international trials are available. |