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Thromboangiitis
obliterans
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Normal |
Abnormal |
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Thromboangiitis obliterans is also known as Buerger's Disease,
and it is most often seen in young men who smoke. This
disease causes blood circulation to the hands and feet to
cut off, leading to pain, numbness, infections, and/or loss
of the affected limb. Treatment is to stop smoking
immediately and to take care of the
limbs.
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- All of the symptoms are due to the
lack of circulation.
- People with this disease often have a history of Thrombophlebitis
(inflammation and sometimes infection) of the superficial
blood vessels in the limbs.
- The patient may have pain in his
leg or calf that worsens with walking and improves with
rest. However, if the disease is really advanced and the
circulation is poor, he may experience pain in the limb even
at rest.
- The patient may also have numbness,
a burning sensation, or pain in the affected limb.
- In some, the foot or hand may be
pale and cold, while others may have reddened skin.
- The pulse in the wrist, foot, and
elbow may be decreased or absent.
- There may be skin ulcers on the
hands or feet.
- Usually the patient has symptoms in
both hands or in both feet, but not necessarily equally.
- The patient may also notice that
his fingers or toes turn different colors (white, blue, and
then red) when they are upset, or exposed to cold weather.
- The symptoms may come and go until
the circulation is so poor that the patient starts to
develop ulcers and eventually gangrene of the fingers or
toes.
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- The disease is caused by
inflammation and blockage of some of the blood vessels in
the body. It usually affects the arteries that supply the
feet and hands.
- The cause of the inflammation is
not known.
- It is seen most often in men under
the age of 40 who smoke.
- It is common in Ashkenazi Jews from
Eastern Europe.
- The symptoms of the disease are
caused by blockage of the arteries, which leads to lack of
circulation.
- The feet are more commonly affected
than the hands.
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- An examination usually reveals a
decrease or absence of pulses in the extremities.
- Blood tests are usually normal.
- An angiogram (in which a dye is injected into the blood vessel and then X-Rays taken) may help with
the diagnosis, and may rule out other causes.
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- The main treatment is to STOP
SMOKING immediately. If the patient keeps smoking, then the
disease will continue to proceed and become more severe.
- Once the patient stops smoking,
then taking good care of the hands and feet is very
important.
- If infections or ulcers develop,
they must be treated very quickly and aggressively to
prevent spreading.
- If the ulcers do not heal or if
gangrene develops, then amputation may be necessary.
- In some people with the disease,
they may need to have some of the nerves cut (sympathectomy)
to help relieve the spasming of the blood vessel, and also
to help relieve some of the pain.
- If people with this disease stop
smoking soon enough and take good care of their hands and
feet, then they may never need any amputation.
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- Atherosclerotic disease
- Raynaud's Disease
- Antiphospholipid antibody syndrome
- Cholesterol atheroembolic disease
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