Buerger's disease

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A chronic inflammatory disease of the peripheral vessels forming blood clots that results in reduced blood flow, possible ulceration, and gangrene.

Description

A chronic inflammatory disease of the peripheral vessels, chiefly of the radial and ulnar arteries, sometimes also involving the arteries of the lower limbs, forming blood clots that results in reduced blood flow, possible ulceration, and gangrene. Severe pain of extremities at rest (first symptom in four-fifths of cases), resembling that of intermittent claudication, which usually causes insomnia. Other features include cold sensation at extremities, cold hypersensibility, sudden sweating, dyshidrosis, occasionally, Raynaud’s phenomenon. Central nervous system involvement may include focal lesions of the cerebral cortex with resulting paralysis, sensory disorders, convulsions, aphasia, hemianopsia, personality changes, and mental deterioration. It occurs almost exclusively in males (75 : 1), with a propensity for people of Jewish descent. Larger incidence among cigarette-smoking men between 28 and 50 years of age. Aetiology unknown.

This disease was mentioned already by the late fifth century B.C. Greek historian Thucydides. In modern times it was first described in 1876 by the German pathologist and bacteriologist Carl Friedländer (1847-1887) as arteritis obliterans. Felix von Winiwarter in 1879 described a male patient aged 57. Burger described it in 1908, and later, in 1924, he published a monograph based on the material from 500 patients.

Bibliography

  • Carl Friedländer:
    Arteriitis obliterans.
    Zentralblatt für die medizinischen Wissenschaften, Berlin, 1876, 14.
  • F. von Winiwarter:
    Über eine eigenthümliche Form von Endarteriitis und Endophlebitis mit Gangrän des Fusses.
    Archiv für klinische Chirurgie, Berlin, 1879, 23: 202-226.
  • W. Zoege von Manteuffel:
    Über angiosclerotische Gangrän.
    Archiv für klinische Chirurgie, Berlin, 1891, 42: 569-574.
  • W. Zoege von Manteuffel:
    Über die Ursachen des Gefässverschlusses bei Gangrän.
    Deutsche Zeitschrift für Chirurgie, Leipzig, 1898, 47: 463-475.
  • L. Buerger:
    Thrombo-angiitis obliterans: a study of the vascular lesions leading to presenile spontaneous gangrene.
    American Journal of the Medical Sciences, Thorofare, N.J., 1908, 136: 567-580.

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