What is the definition of Buerger Disease?
Buerger disease is a disease in which small and medium-sized blood vessels in the arms and/or legs become inflamed and blocked (vasculitis). This reduces blood flow to affected areas of the body, eventually resulting damage to tissues. Symptoms of Buerger disease may include coldness, numbness, tingling or burning, and pain. Symptoms may first be felt in the fingertips or toes, and then move further up the arms or legs. Additional symptoms that may develop include changes in the texture and color of the skin, Raynaud's phenomenon, painful muscle cramps, swelling (edema), skin ulcers, and gangrene. Rare complications that have been reported include transient ischemic attacks or stroke, and heart attack.
Buerger disease almost always occurs in people who use tobacco, but it is not known exactly how tobacco plays a role in the development of the disease. Some people may have a genetic predisposition to Buerger disease. It is also possible that Buerger disease is an autoimmune disease, as the immune system seems to play a large role in its development. More research is needed to identify the exact underlying causes.
Quitting all forms of tobacco is an essential part of stopping the progression of the disease. There are no definitive treatments, but certain therapies may improve symptoms in some people. Therapies that have been reported with varying success include medications to improve blood flow and reduce the risk of clots, pain medicines, compression of the arms and legs, spinal cord stimulation, and surgery to control pain and increase blood flow. Amputation may be necessary if gangrene or a serious infection develops.
What are the alternative names for Buerger Disease?
- Buerger's disease
- Thromboangiitis obliterans
- Inflammatory occlusive peripheral vascular disease
- Occlusive peripheral vascular disease
What are the causes for Buerger Disease?
Buerger disease has a strong relationship to cigarette smoking. This association may be due to direct poisoning of cells from some component of tobacco, or by hypersensitivity to the same components. Many people with Buerger disease will show hypersensitivities to injection of tobacco extracts into their skin. There may be a genetic component to susceptibility to Buerger disease as well. It is possible that these genetic influences account for the higher prevalence of Buerger disease in people of Israeli, Indian subcontinent, and Japanese descent. Certain HLA (human leukocyte antigen) haplotypes have also been found in association with Buerger disease.
What are the current treatments for Buerger Disease?
Currently there is not a cure for Buerger disease, however there are treatments that can help control it. The most essential part of treatment is to avoid all tobacco and nicotine products. Even one cigarette a day can worsen the disease. A doctor can help a person with Buerger disease learn about safe medications and programs to combat smoking/nicotine addiction. Continued smoking is associated with an overall amputation rate of 40 to 50 percent.
The following treatments may also be helpful, but do not replace smoking/nicotine cessation:
Medications to dilate blood vessels and improve blood flow (e.g., intravenous Iloprost)
Medications to dissolve blood clots
Treatment with calcium channel blockers
Intermittent compression of the arms and legs to increase blood flow to your extremities
Surgical sympathectomy (a controversial surgery to cut the nerves to the affected area to control pain and increase blood flow)
Therapeutic angiogenesis (medications to stimulate growth of new blood vessels)
Spinal cord stimulation
Amputation, if infection or gangrene occurs