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Buerger disease

Última revisão: 12 Aug 2025
Última atualização: 07 Dec 2021

Resumo

Definição

História e exame físico

Outros fatores diagnósticos

  • paresthesias/cold sensation/cyanosis in limb or finger
  • ulceration/gangrene
  • claudication
  • rest pain
  • superficial thrombophlebitis
  • cold limb or finger
  • pale limb or finger
  • absence of distal pulses
  • positive Allen test
  • joint arthritis
  • duration of joint symptoms up to 2 weeks
Detalhes completos

Fatores de risco

  • smoking
  • age <40 years
  • region of origin: southeast Mediterranean, Middle East, and Far East
  • male sex
  • periodontal infection
  • human leukocyte antigen (HLA) haplotypes
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • blood glucose
  • BUN
  • serum creatinine
  • complete blood count (CBC) with differential
  • coagulation screen
  • thrombophilia screen
  • C-reactive protein (CRP)
  • erythrocyte sedimentation rate (ESR)
  • arterial Doppler
Detalhes completos

Investigações a serem consideradas

  • antinuclear antibody
  • rheumatoid factor
  • antineutrophilic cytoplasmic antibody (ANCA)
  • complement levels
  • anticentromere antibody
  • topoisomerase I antibodies (Scl-70)
  • echocardiogram
  • arterial duplex
  • digital subtraction angiography
  • anticardiolipin antibodies
Detalhes completos

Novos exames

  • CT angiography
  • magnetic resonance angiography
  • tissue biopsy
  • genetic testing

Algoritmo de tratamento

AGUDA

critical ischemia

CONTÍNUA

noncritical ischemia

Colaboradores

Autores

Matthew J. Metcalfe, MD, FRCS, FEBVS, FHEA
Matthew J. Metcalfe

Consultant Vascular Surgeon

Lister Hospital

East and North Hertfordshire NHS Trust

Hertfordshire

UK

Declarações

MJM declares that he has no competing interests.

Alun H. Davies, MA, DM, FRCS, FHEA
Alun H. Davies

Professor of Vascular Surgery and Honorary Consultant Surgeon

Department of Vascular Surgery

Faculty of Medicine

Imperial College of Medicine

Charing Cross Hospital

London

UK

Declarações

AHD declares that he has no competing interests.

Revisores

Kosmas I. Paraskevas, MD, FASA

Department of Vascular Surgery

Red Cross Hospital

Athens

Greece

Declarações

KIP declares that he has no competing interests.

Maureen K. Sheehan, MD

Assistant Professor of Surgery

Division of Vascular Surgery

University of Texas Health Science Center at San Antonio

San Antonio

TX

Declarações

MKS declares that she has no competing interests.

Peter F. Lawrence, MD

Chief of Vascular Surgery

Director

Gonda Vascular Center

David Geffen School of Medicine at UCLA

Los Angeles

CA

Declarações

PFL declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Lie JT. The rise and fall and resurgence of thromboangiitis obliterans (Buerger's disease). Acta Pathol Jpn. 1989 Mar;39(3):153-8. Resumo

Olin JW, Young JR, Graor RA, et al. The changing clinical spectrum of thromboangiitis obliterans (Buerger's disease). Circulation. 1990 Nov;82(5 suppl):IV3-8. Resumo

Buerger L. Thrombo-angiitis obliterans: a study of the vascular lesions leading to presenile spontaneous gangrene. Am J Med Sci. 1908 Nov;136(5):567-80.

Papa MZ, Rabi I, Adar R. A point scoring system for the clinical diagnosis of Buerger's disease. Eur J Vasc Endovasc Surg. 1996 Apr;11(3):335-9. Resumo

Ohta T, Ishioashi H, Hosaka M, et al. Clinical and social consequences of Buerger disease. J Vasc Surg. 2004 Jan;39(1):176-80. Resumo

Cacione DG, Macedo CR, do Carmo Novaes F, et al. Pharmacological treatment for Buerger's disease. Cochrane Database Syst Rev. 2020 May 4;5:CD011033.Texto completo  Resumo

Artigos de referência

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