Doença de Buerger
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
- Angiotomografia
- angiografia por ressonância magnética
- biópsia tecidual
- anticorpos anticardiolipina
Emerging tests
- 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 and West Essex Vascular Network
Hertfordshire
UK
Disclosures
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
Disclosures
AHD declares that he has no competing interests.
Peer reviewers
Kosmas I. Paraskevas, MD, FASA
Department of Vascular Surgery
Red Cross Hospital
Athens
Greece
Disclosures
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
Disclosures
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
Disclosures
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.
References
Key articles
Le Joncour A, Soudet S, Dupont A, et al. Long-term outcome and prognostic factors of complications in thromboangiitis obliterans (Buerger's disease): a multicenter study of 224 patients. J Am Heart Assoc. 2018 Dec 4;7(23):e010677.Full text Abstract
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. Abstract
Ohta T, Ishioashi H, Hosaka M, et al. Clinical and social consequences of Buerger disease. J Vasc Surg. 2004 Jan;39(1):176-80. Abstract
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.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Doença embólica
- Estado hipercoagulável
- fenômeno de Raynaud (FR)
More DifferentialsPatient information
Abandono do hábito de fumar
Fenômeno de Raynaud
More Patient information
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer