Buerger Disease (Thromboangiitis Obliterans)

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Buerger Disease, also known as Thromboangiitis Obliterans, is a medium vessel vasculitis that is strongly associated with smoking. Classically, the disease is seen in heavy smokers who are young males between the ages of 20 through 40.

Symptoms begin with intermittent claudication (pain with muscle use) and Raynaud phenomenon (fingers blue in the cold due to vasoconstriction). More severe finding include gangrene and autoamputation of the digits. Involvement of the veins presents as superficial nodular thrombophlebitis, which refers to pain and inflammation along veins.

Pathology on biopsy reveals a segmental thrombosing vasculitis with vein and nerve involvement. Smoking cessation is not curative, but it has been shown to slow progression and severity of Buerger disease.

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