BUERGER’S DISEASE: ANOTHER REASON TO QUIT SMOKING.

Described as a nonatherosclerotic vascular disease also known as thromboangiitis obliterans, is characterized by the absence or minimal presence of atheromas, segmental vascular inflammation, vasoocclusive phenomenon, and involvement of small- and medium-sized arteries and veins of the upper and lower extremities (Hanly, 2009).

Seen in heavy smoker, it present with intermittent claudication, superficial nodular phlebitis, raynaud’s phenomenon (cold sensitivity), severe pain in affected part (Tao, Bhushan, Tolles, & Hofmann, 2011); medium vessels disease cause thrombosis and/or infarction of arteies that lead to gangrene and autoamputation of digits.

Smoking  is considered as a precipitating factor of  the disease, its progression is very associated with continued use of tabacco, found the coexistence with other atherosclerotic risk factors like disturbances of glucose metabolism (Malecki, Zdrojowy, & Adamiec, 2009).

The smoking cessation is the only way to stop the disease.

Most patients have significant improvement in symptoms if smoking is discontinued, Lawrence at el. report a patient who experienced progression of biopsy-proven Buerger's disease, after substituting smokeless tobacco for cigarettes. The association of smokeless tobacco with progressive limb ischemia should lead clinicians to discourage the substitution of smokeless tobacco for cigarette smoking in patients with Buerger's disease. (Lawrence, Lund, Jimenez, & Muttalib, 2008).

Bibliography

Hanly, E. J. (2009, may 1). medscape.com. Retrieved jan 17, 2011, from Burger Disease (Thromboangiitis Obliterans): http://emedicine.medscape.com/article/460027-overview

Lawrence, P., Lund, O., Jimenez, J., & Muttalib, R. (2008). Substitution of smokeless tabacco for cigarettes in Buerger's disease does not prevent limb loss. J Vasc Surg , 48 (1):210-2 (ISSN: 0741-5214.

Malecki, R., Zdrojowy, K., & Adamiec, R. (2009). Thromboangiitis obliterans in the 21st century--a new face of disease. Atherosclerosis , 206(2):328-34 (ISSN:1879-1484).

Tao, L., Bhushan, V., Tolles, J., & Hofmann, J. (2011). Fisrt AID for USMLE step1. usa: McGraw Hill.