| Buerger's disease is a
circulatory disease that is brought on by chronic inflammation of the
blood vessels in the extremities. Also called thromboangiitis obliterans ,
Buerger's disease is most common with people who smoke.
It normally affects the foot or lower leg, but it may occur in the hand, arm, or
thigh as well. Early signs of Buerger’s disease are a tingling sensation like
"pin pricks" and a burning sensation in the fingers and toes. It can
lead to ulceration and gangrene; in severe cases, amputation may be
required. There are other disorders associated with circulatory problems. When
plaque or fatty deposits form along the walls of the arteries, it causes them to
harden and constrict. Hypertension, or high
blood pressure, results because the blood exerts greater force against the
walls of the narrowed and/or more rigid blood vessels. Hypertension can
lead to stroke, angina
pectoris (chest pain), kidney damage, and heart
attack. Another serious circulatory condition is Raynaud's
phenomenon , which is characterized by constriction and spasm of the
blood vessels in the body extremities, like fingers, toes, and tip of the nose.
Cold, stress, smoking, and other factors may cause fingers and
toes to become numb; extremities may appear colorless or bluish due to lack of
circulation and arterial spasm. This disease most commonly affects women
and sometimes may lead to gangrene. Poor circulation
can also result from varicose veins, which
develop because of a loss and weakening of elasticity in the vein walls. click
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|An exact diagnosis of Buerger's disease "thromboangiitis
obliterans" is difficult because it relies heavily excluding
other conditions. The most commonly followed diagnostic criteria are outlined
below; however, the criteria tend to differ slightly from author to author and
Olin proposes the following criteria:
1. Male between 20 to 40 years old but recently females have been diagnosed.
2. Current (or recent) history of tobacco use (smoking)
3. Presence of distal extremity ischemia that is indicated by claudication, pain
at rest, ischemic ulcers or gangrene documented by noninvasive vascular testing
such as an ultrasound test.
4. Excluding other autoimmune diseases, hypercoagulable states, and diabetes
mellitus by lab tests.
5. Exclusion of a proximal source of emboli by both echocardiography and
6. Consistent arteriographic findings in the clinically involved and
non-involved limbs of the body.
Buerger’s disease may be imitated by a variety of other diseases that cause
diminished blood flow circulation to the the person's body extremities. These
other diseases or disorders must be ruled out with an accurate evaluation,
because their treatments may differ substantially from that of Buerger’s
disease. For Buerger’s there is no treatment considered to be an effective
Diseases with which Buerger’s disease might be confused include
1. Atherosclerosis - a
build-up of cholesterol plaques in the arteries
2. Endocarditis - an infection of the lining of the heart
3. Other types of vasculitis
4. Raynaud’s phenomenon associated with connective tissue disorders (e.g., lupus
5. Clotting disorders of the blood
Angiograms of both the patient's upper and lower extremities may be helpful
in making the diagnosis of Buerger’s disease. In the right clinical setting,
certain angiographic findings are diagnostic of Buerger’s whose findings
include a corkscrew appearance of arteries that result from vascular
damage, especially the arteries in the person's wrists and/or ankles. Angiograms
can also show blockages or narrowings in several areas of both the arms and legs
of the patient. These changes are normally particularly apparent in the blood
vessels in the ulnar artery distribution.
To rule out the various other forms of vasculitis it is needed to exclude
involvement of vascular regions atypical for Buerger’s disease, so it is in
some cases necessary to perform angiograms of the person's other body regions
such as a mesenteric angiogram.
Skin biopsies of the affected extremities are normally not performed because
of concern that a biopsy site near an area that is poorly perfused with blood
will not heal very well just causing additional problems.
Doctor's Comments about Drugs
"The person who takes medicine must recover twice, once
from the disease and once from the medicine." William Osler, M.D.
"The cause of most disease is in the poisonous drugs
physicians superstitiously give in order to effect a cure." Charles E.
"If all the medicine in the world were thrown into the sea,
it would be bad for the fish and good for humanity."
O.W. Holmes, (Prof. of Medicine Harvard University)
"Every drug increases and complicates the patients
condition." Robert Henderson, M.D.
"In sickness the body is already loaded with impurities. By
taking drug - medicines more impurities are added, thereby the case is further
embarrassed and harder to cure." Elmer Lee, M.D.
"The necessity of teaching mankind not to take drugs and
medicines, is a duty incumbent upon all who know their uncertainty and injurious
effects; and the time is not far distant when the drug system will be
abandoned." Charles Armbruster, M.D.
See the website www.drugs.com
to look up possible side effects
of any prescription drugs or medications that you are using.
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