Vasculitis & Other Misc. Vascular


Beurger Disease
Autoimmune disease strongly assoc. with smoking
Multifactorial; some allergen associated with tobacco use
Perivascular inflammation of small, medium-sized arteries, veins and nerves, thrombus formation.
Usually vessels of extermeties, sometimes aortic, cerebral, coronary, mesenteric, pulmonary or renal
- mesenteric = rare and deadly.
Onset in young people <45, early symptoms are intermittent and distal.
Cyanotic and erythmatous extremeties.
Vessel biopsy shows cellular thrombus and classic acute-phase lesions
- but usually enough to do history and physical; biopsies rarely necessary
- exclude other casculitis conditions
Treated with:
1. Smoking cessation
2. Evaluation of limb and revascularization as appropriate
3. Endovascular therapies not suually as helpful due ot distal, diffuse, segmental disease; typically need femorodistal bypass
Expect periods of remission and exacerbation, overall poor quality of life and amputations if do not give up smoking