Thromboangiitis obliterans
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Thromboangiitis obliterans, abbreviated TAO, is a rare vascular disease characterized by recurrent thrombosis. It primarily afflicts young smokers and is also known as Buerger disease.
It should not be confused with Berger disease (IgA nephropathy).
General
Typical symptoms/signs - progression:[3]
- Intermittent claudication -> ulcers -> gangrene -> amputation.
Treatment:
- Stop smoking.[3]
Gross
- Afflicts small and medium-sized vessels of the extremities.
- Corkscrew vessels - seen on angiography.[2]
Microscopic
Features:[4]
- Acute inflammation:
- Endarteritis - neutrophils at the internal elastic lamina (IEL).
- Periarteritis - neutrophils around the arteries.
- Obliteration of the lumen - intimal thickening.
Notes:
- Typically segmental.[3]
DDx:
- Peripheral vascular disease (atherosclerosis) - typically lacks the acute inflammation around the IEL and around the vessels.
- Vasculitis - have fibrinoid necrosis.
Images:
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MIDDLE FINGER DISTAL PHALYNX, LEFT, AMPUTATION: - GANGRENE WITH ENDARTERITIS, PERIARTERITIS AND LUMINAL OBLITERATION/NARROWING CONSISTENT WITH THROMBOANGIITIS OBLITERANS (BUERGER'S DISEASE).
See also
References
- ↑ Highlander, P.; Southerland, CC.; VonHerbulis, E.; Gonzalez, A. (Jan 2011). "Buerger disease (thromboangiitis obliterans): a clinical diagnosis.". Adv Skin Wound Care 24 (1): 15-7. doi:10.1097/01.ASW.0000392923.37852.43. PMID 21173586.
- ↑ 2.0 2.1 Fujii, Y.; Soga, J.; Nakamura, S.; Hidaka, T.; Hata, T.; Idei, N.; Fujimura, N.; Nishioka, K. et al. (Aug 2010). "Classification of corkscrew collaterals in thromboangiitis obliterans (Buerger's disease): relationship between corkscrew type and prevalence of ischemic ulcers.". Circ J 74 (8): 1684-8. PMID 20534945.
- ↑ 3.0 3.1 3.2 Dargon, PT.; Landry, GJ. (Aug 2012). "Buerger's disease.". Ann Vasc Surg 26 (6): 871-80. doi:10.1016/j.avsg.2011.11.005. PMID 22284771.
- ↑ Kurata, A.; Schulz, A.; Franke, FE. (2004). "Reappraisal of thromboangiitis obliterans--a pathological contribution.". Verh Dtsch Ges Pathol 88: 231-6. PMID 16892557.