Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
Other diagnostic factors
- parestesias/sensação de frio/cianose no membro ou dedo
- ulceração/gangrena
- claudicação
- dor em repouso
- tromboflebite superficial
- membro ou dedo frio
- membro ou dedo pálido
- ausência de pulsos distais
- teste de Allen positivo
- artrite
- duração de até 2 semanas dos sintomas articulares
Risk factors
- tabagismo
- idade <40 anos
- região de origem: sudeste do Mediterrâneo, Oriente Médio e Extremo Oriente
- sexo masculino
- infecção periodontal
- haplótipos do antígeno leucocitário humano (HLA)
Diagnostic tests
1st tests to order
- glicose sanguínea
- ureia
- creatinina sérica
- hemograma completo com diferencial
- coagulograma
- rastreamento para trombofilia
- proteína C-reativa
- velocidade de hemossedimentação (VHS)
- Doppler arterial
Tests to consider
- anticorpo antinuclear
- fator reumatoide
- anticorpo anticitoplasma de neutrófilo (ANCA)
- níveis do complemento
- anticorpo anticentrômero
- anticorpos antitopoisomerase I (Scl-70)
- ecocardiograma
- duplex arterial
- angiografia digital por subtração
- anticorpos anticardiolipina
Emerging tests
- Angiotomografia
- angiografia por ressonância magnética
- biópsia tecidual
- teste genético
Treatment algorithm
isquemia crítica
isquemia não crítica
Contributors
Authors
Matthew J. Metcalfe, MD, FRCS, FEBVS, FHEA
Consultant Vascular Surgeon
Lister Hospital
East and North Hertfordshire NHS Trust
Hertfordshire
UK
Divulgaciones
MJM declares that he has no competing interests.
Alun H. Davies, MA, DM, FRCS, FHEA
Professor of Vascular Surgery and Honorary Consultant Surgeon
Department of Vascular Surgery
Faculty of Medicine
Imperial College of Medicine
Charing Cross Hospital
London
UK
Divulgaciones
AHD declares that he has no competing interests.
Revisores por pares
Kosmas I. Paraskevas, MD, FASA
Department of Vascular Surgery
Red Cross Hospital
Athens
Greece
Divulgaciones
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
Divulgaciones
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
Divulgaciones
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.
Referencias
Artículos principales
Lie JT. The rise and fall and resurgence of thromboangiitis obliterans (Buerger's disease). Acta Pathol Jpn. 1989 Mar;39(3):153-8. Resumen
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. Resumen
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. Resumen
Ohta T, Ishioashi H, Hosaka M, et al. Clinical and social consequences of Buerger disease. J Vasc Surg. 2004 Jan;39(1):176-80. Resumen
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 Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Doença embólica
- Estado hipercoagulável
- fenômeno de Raynaud (FR)
Más DiferencialesFolletos para el paciente
Abandono do hábito de fumar
Fenômeno de Raynaud
Más Folletos para el paciente
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