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Difference between revisions of "Thromboangiitis obliterans"
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===Formal clinical criteria=== | ===Formal clinical criteria=== | ||
All of the following - as per '' | ====Simple==== | ||
All of the following - as per ''Shionoya'':<ref name=pmid16722538>{{Cite journal | last1 = Arkkila | first1 = PE. | title = Thromboangiitis obliterans (Buerger's disease). | journal = Orphanet J Rare Dis | volume = 1 | issue = | pages = 14 | month = | year = 2006 | doi = 10.1186/1750-1172-1-14 | PMID = 16722538 | URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1523324/ | PMC = 1523324 }}</ref> | |||
*Smoking. | |||
**No other atherosclerosis risk factors. | |||
*Onset < 50 years old. | |||
*Infrapopliteal arterial occlusions. | |||
*Arm involvement ''or'' phlebitis migrans; | |||
====Complicated==== | |||
All of the following - as per ''Olin'':<ref name=pmid10995867>{{Cite journal | last1 = Olin | first1 = JW. | title = Thromboangiitis obliterans (Buerger's disease). | journal = N Engl J Med | volume = 343 | issue = 12 | pages = 864-9 | month = Sep | year = 2000 | doi = 10.1056/NEJM200009213431207 | PMID = 10995867 | URL = http://www.nejm.org/doi/full/10.1056/NEJM200009213431207 }}</ref> | |||
*Less than 45 years old. | *Less than 45 years old. | ||
*Current or recent tobacco use. | *Current or recent tobacco use. | ||
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*Arteriographic findings consistent with the disease. | *Arteriographic findings consistent with the disease. | ||
Exclusions - with lab tests:<ref name=pmid16722538 | Exclusions - with lab tests:<ref name=pmid16722538/> | ||
*Autoimmune disease. | *Autoimmune disease. | ||
*Hypercoagulable state. | *Hypercoagulable state. | ||
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** Endarteritis - neutrophils at the internal elastic lamina (IEL). | ** Endarteritis - neutrophils at the internal elastic lamina (IEL). | ||
** Periarteritis - neutrophils around the arteries. | ** Periarteritis - neutrophils around the arteries. | ||
* | *Luminal narrowing due to thrombi.<ref name=pmid16722538/> | ||
** | **Organizing thrombi = thickened tunica intima. | ||
** | **Vessels may be re-canalized. | ||
Notes: | Notes: | ||
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==Sign out== | ==Sign out== | ||
<pre> | <pre> | ||
MIDDLE FINGER DISTAL | MIDDLE FINGER DISTAL PHALANX, LEFT, AMPUTATION: | ||
- ENDARTERITIS, PERIARTERITIS | - ENDARTERITIS, PERIARTERITIS, INTRAVASCULAR THROMBI AND GANGRENE CONSISTENT WITH | ||
THROMBOANGIITIS OBLITERANS (BUERGER'S DISEASE). | THROMBOANGIITIS OBLITERANS (BUERGER'S DISEASE). | ||
</pre> | </pre> | ||