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Publications > The New England Journal of Medicine

Throlboangiitis Obliterans (Buerger’s Disease)

Current Concepts
THROMBOANGIITIS obliterans (Buerger’s disease) is a nonatherosclerotic segmental inflammatory disease that most commonly affects the small and medium-sized arteries, veins, and nerves of the arms and  legs.1 Von Winiwarter first described a patient with thromboangiitis obliterans in 1879.2 Twenty-nine years later, Leo Buerger provided a detailed and accurate description of the pathological findings in 11  amputated limbs.3 Thromboangiitis obliterans differs from other forms of vasculitis in some important ways. Pathologically, there is a highly cellular and inflammatory thrombus with relative sparing of the blood-vessel wall. The acute-phase reactants (as assessed by the Westergren sedimentation rate and serum C-reactive protein level) are usually normal. Results of serologic tests for the immunologic markers (circulating immune complexes, complement levels, and cryoglobulins) and the commonly measured autoantibodies (antinuclear antibody and rheumatoid factor) are normal or negative, yet an immune reaction has been demonstrated in the arterial intima.4 ...
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