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Pathophysiology
Clinical meaning
Buerger's disease causes segmental inflammation and thrombosis of small and medium arteries and veins, primarily in the extremities. Unlike atherosclerosis, the vessel wall remains intact but becomes heavily infiltrated with inflammatory cells and thrombus. It occurs almost exclusively in smokers.
Exam Focus
Exam relevance
Risk factors:
- Tobacco use (essential for diagnosis)
- Male sex (historically, though female incidence rising)
- Age 20-40 years
- Southeast Asian or Middle Eastern descent
- Cannabis use (emerging risk)
- Heavy smoking (>1.5 packs/day)
Diagnostics:
- Expect arteriography showing 'corkscrew' collateral vessels
- Monitor Allen test result
- Expect CBC and inflammatory markers
- Monitor pedal and radial pulses
- Expect autoimmune panel to rule out other vasculitis
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