Obliterating trombangiitis

Template:Infobox - onemocnění Trombangiitis obliterans (Bürger's disease) is very rare today (Slovakia, Poland, V Europe, S Africa, Asia). It mainly affects young men, smokers and leads to amputations of the lower and upper limbs.

Etiology and pathogenesis

The etiology is unknown. Genetic influences (more in the yellow race), tobacco smoking , infections, low level of hygiene apply . An inflammatory process occurs with granulomas in the arteries (small and medium) and veins of the upper and lower limbs. In the vessels of the limbs, we find extensive thromboses , which lead to severe ischemia of the limb.

Clinical picture

• on the limbs, migrating phlebitis – inflammatory infiltrates of several centimeters in the course of the veins, after a few days they subside and appear in another place;
• spasms of digital arteries → pallor of fingers;
• there may be plantar claudication;
• progressive necrosis and gangrene of the fingers

Diagnostics

• arteriography:normal findings on proximal arteries, extensive "carrot-shaped" obliteration of small distal arteries + long, thin "corkscrew-shaped" collaterals;
• laboratory: signs of inflammation at the time of deterioration, no hyperlipidemia ;
• untreated disease occurs in fits - exacerbations are associated with new occurrence of migrating phlebitis, ischemia progresses + repeated amputations are necessary

therapy

• absolute cessation of smoking , treatment of infections, anti-inflammatory drugs for phlebitis;
• treatment of ischemia similar to that of other diseases ( revascularization options limited);
• sympathectomy.

Links

Související články

• Trombóza
• Zánět