Overview

Buerger's disease (thromboangiitis obliterans) is a rare disease of the arteries and veins in the arms and legs. In Buerger's disease, your blood vessels become inflamed, swell and can become blocked with blood clots (thrombi).

This eventually damages or destroys skin tissues and may lead to infection and gangrene. Buerger's disease usually first shows in your hands and feet and may eventually affect larger areas of your arms and legs.

Virtually everyone diagnosed with Buerger's disease smokes cigarettes or uses other forms of tobacco, such as chewing tobacco. Quitting all forms of tobacco is the only way to stop Buerger's disease. For those who don't quit, amputation of all or part of a limb is sometimes necessary.

Source: http://www.mayoclinic.com

Symptoms

Buerger's disease symptoms include:

• Pain that may come and go in your legs and feet or in your arms and hands. This pain may occur when you use your hands or feet and eases when you stop that activity (claudication), or when you're at rest
• Inflammation along a vein just below the skin's surface (due to a blood clot in the vein)
• Fingers and toes that turn pale when exposed to cold (Raynaud's phenomenon)
• Painful open sores on your fingers and toes

When to see a doctor

See your doctor if you think you may have signs or symptoms of Buerger's disease.

Source: http://www.mayoclinic.com

Causes

The exact cause of Buerger's disease is unknown. While tobacco use clearly plays a role in the development of Buerger's disease, it's not clear how it does so.

Experts suspect that some people may have a genetic predisposition to the disease. It's also possible that the disease is caused by an autoimmune response in which the body's immune system mistakenly attacks healthy tissue.

Source: http://www.mayoclinic.com

Diagnosis

While no tests can confirm whether you have Buerger's disease, your doctor will likely order tests to rule out other more common conditions or confirm suspicion of Buerger's disease brought on by your signs and symptoms. Tests may include:

Blood tests

Blood tests to look for certain substances can rule out other conditions that may cause similar signs and symptoms. For instance, blood tests can help rule out scleroderma, lupus, blood-clotting disorders and diabetes, along with other diseases and conditions.

The Allen's test

Your doctor may perform a simple test called the Allen's test to check blood flow through the arteries carrying blood to your hands. In the Allen's test, you make a tight fist, which forces the blood out of your hand. Your doctor presses on the arteries at each side of your wrist to slow the flow of blood back into your hand, making your hand lose its normal color.

Next, you open your hand and your doctor releases the pressure on one artery, then the other. How quickly the color returns to your hand may give a general indication about the health of your arteries. Slow blood flow into your hand may indicate a problem, such as Buerger's disease.

Angiogram

An angiogram helps to see the condition of your arteries. An angiogram can be done non-invasively with the use of CT or MRI scans.

Or it may be done by threading a catheter into an artery. During this procedure, a special dye is injected into the artery, after which you undergo a series of rapid X-rays. The dye helps to delineate any artery blockages that show up on the images.

Your doctor may order angiograms of both your arms and your legs — even if you don't have signs and symptoms of Buerger's disease in all of your limbs. Buerger's disease almost always affects more than one limb, so even though you may not have signs and symptoms in your other limbs, this test may detect early signs of vessel damage.

Source: http://www.mayoclinic.com

Complications

If Buerger's disease worsens, blood flow to your arms and legs decreases. This is due to blockages that make it hard for blood to reach the tips of your fingers and toes. Tissues that don't receive blood don't get the oxygen and nutrients they need to survive.

This can cause the skin and tissue on the ends of your fingers and toes to die (gangrene). Signs and symptoms of gangrene include black or blue skin, a loss of feeling in the affected finger or toe, and a foul smell from the affected area. Gangrene is a serious condition that usually requires amputation of the affected finger or toe.

Source: http://www.mayoclinic.com

Prevention

Quit using tobacco in any form

Virtually everyone who has Buerger's disease has used tobacco in some form, most prominently cigarettes. To prevent Buerger's disease, it's important to not use tobacco.

Quitting smoking can be hard. If you're like most people who smoke, you've probably tried to quit in the past. It's never too late to try again. Talk to your doctor about strategies to help you quit.

Lifestyle and home remedies

Take care of your fingers and toes if you have Buerger's disease. Check the skin on your arms and legs daily for cuts and scrapes, keeping in mind that if you've lost feeling to a finger or toe you may not feel, for example, a cut when it happens. Keep your fingers and toes protected and avoid exposing them to cold.

Low blood flow to your extremities means your body can't resist infection as easily. Small cuts and scrapes can easily turn into serious infections.

Clean any cut with soap and water, apply antibiotic ointment, and cover it with a clean bandage. Keep an eye on any cuts or scrapes to make sure they're healing. If they get worse or heal slowly, see your doctor promptly.

Visit your dentist regularly to keep your gums and teeth in good health and avoid gum disease, which in its chronic form is linked to Buerger's disease.

Source: http://www.mayoclinic.com

Risk factors

Tobacco use

Cigarette smoking greatly increases your risk of Buerger's disease. But Buerger's disease can occur in people who use any form of tobacco, including cigars and chewing tobacco. People who smoke hand-rolled cigarettes using raw tobacco may have the greatest risk of Buerger's disease.

It isn't clear how tobacco use increases your risk of Buerger's disease, but virtually everyone diagnosed with Buerger's disease uses tobacco. It's thought that chemicals in tobacco may irritate the lining of your blood vessels, causing them to swell. The rates of Buerger's disease are highest in areas of the Mediterranean, Middle East and Asia where heavy smoking is most common.

Chronic gum disease

Long-term infection of the gums also is linked to the development of Buerger's disease.

Sex

Buerger's disease is far more common in males than in females. However, this difference may be linked to higher rates of smoking in men.

Age

The disease often first appears in people less than 45 years old.

Source: http://www.mayoclinic.com