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Buerger disease
Other Resources UpToDate PubMed

Buerger disease

Contributors: Art Papier MD, Jeffrey D. Bernhard MD, Noah Craft MD, PhD
Other Resources UpToDate PubMed

Synopsis

Buerger disease (thromboangiitis obliterans) is a non-atherosclerotic, vaso-occlusive disorder of small- and medium-sized arteries and veins strongly associated with tobacco use. First reported in 1908 by Buerger, the disease is seen worldwide with an increased incidence in Asia and the Middle East. There is a particularly high incidence in Japan. Buerger disease is typically seen in adult men and infrequently women. The precise mechanism of the disease remains unclear. Trauma, cold, and injury to the digits or limbs can trigger an ischemic episode.

Patients with Buerger disease experience claudication, often intense pain, and/or paresthesias in the hands and feet as well as rest pain. The disease can quickly progress to include skin ulcers and gangrene of the digits. Amputation may be needed. Superficial thrombophlebitis is also seen in Buerger disease. Joint involvement with recurrent arthritic symptoms of the large joints can precede the occlusive phase and make early diagnosis difficult. Intestinal involvement with abdominal pain, diarrhea, and even frank melena may rarely occur. There have been rare case reports of scrotal and penile involvement.

Codes

ICD10CM:
I73.1 – Thromboangiitis obliterans [Buerger's disease]

SNOMEDCT:
52403007 – Thromboangiitis obliterans

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Rule out Peripheral arterial disease
  • Scleroderma and CREST syndrome
  • Vasculitis
  • Cryoglobulinemia
  • Cryofibrinogenemia
  • Cholesterol emboli
  • Cannabis arteritis
  • Antiphospholipid antibody syndrome
  • Chilblains (early stage)
  • Raynaud phenomenon (can also be part of Buerger disease)

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated:09/12/2017
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Buerger disease
A medical illustration showing key findings of Buerger disease : Claudication, Cyanosis, Fingers, Gangrene, Painful skin lesions, Skin ulcer, Toes, Smoker
Clinical image of Buerger disease - imageId=2221719. Click to open in gallery.  caption: 'Edema of the right hand and fingers (early edematous phase).'
Edema of the right hand and fingers (early edematous phase).
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