Buerger's disease

Japanese: バージャー病 - バージャーびょう（英語表記）Buerger's disease

What is the disease?

This is a disease in which inflammation of the lining of the peripheral arteries of the limbs (mainly the lower limbs) leads to arterial blockage and blood flow disorders. Thromboangiitis obliterans ( Regular student examination ) It is also called Buerger's disease (English pronunciation) or Bürger's disease (German pronunciation) after the name of the person who first reported it.

The number of patients in Japan is estimated to be about 10,000. The male to female ratio is 10:1, with more men than women, and it is most prevalent among young and middle-aged people, mainly those in their 20s and 40s. Arteriosclerosis obliterans ( Domestic violence prevention committee ) Although similar symptoms occur, occlusive arterial disease is more common in elderly people and rarely occurs in people under the age of 40.

It is a specified disease and medical expenses are eligible for public financial subsidy.

What is the cause?

Although the cause is unknown, smoking is closely related to the onset of the disease. 90% of patients have a smoking history, and when passive smoking (indirect exposure to smoking from smokers around you) is included, it is believed that almost all cases are related to smoking.

How symptoms manifest

When blood flow disorder is mild, coldness and numbness in the lower limbs are observed, and as it becomes more severe, Intermittent claudication ( The relationship is like this ) (When walking a long distance, the legs become painful, but after a short break the pain subsides and the patient is able to walk again) or pain at rest appears. If the blood flow disorder becomes more severe, intractable ulcers may develop. Necrosis ( Replying to @sarah_mcdonald ) This leads to...

The veins in the hands and feet may also become inflamed, causing redness, swelling, and pain along the veins ( Migratory phlebitis ( Yuusoujou Miyakuen ) ).

Testing and diagnosis

The pulsation of the artery beyond the site of blockage cannot be felt. The ratio of blood pressure in the ankle to the upper arm (ankle/brachial blood pressure ratio) is Ischemia ( Excursion ) It is useful for determining the severity of the condition. A definitive diagnosis requires angiography. There are no characteristic findings in blood tests.

Treatment methods

First of all, it is important to strictly abstain from smoking. It is also important to always keep your hands and feet clean and pay attention to keeping warm during the cold season. Be sure to wear shoes that fit your feet well to avoid blisters. Moderate exercise such as walking is recommended.

As for drug therapy, vasodilators and antiplatelet drugs are used to improve blood circulation and prevent blood clots. In severe cases, revascularization such as bypass surgery is performed if possible. When bypass surgery is not suitable, sympathetic ganglion block is performed to dilate blood vessels.

If necrosis progresses and various treatments are ineffective, amputation of the finger or toe may be necessary.

Course of the disease

It does not directly affect the arteries of vital organs (heart, brain, internal organs, etc.) that are related to life. The prognosis for life is the same as for healthy people of the same age, but it may require amputation of fingers or toes, which often threatens the quality of life (QOL).

Early diagnosis, appropriate treatment and strict adherence to smoking cessation can prevent the disease from becoming severe.

Ikeda Uichi

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

どんな病気か

　四肢（主として下肢）の末梢動脈の内膜の炎症により動脈の閉塞を来し、血流障害が生じる病気で、閉塞性血栓血管炎(へいそくせいけっせんけっかんえん)とも呼ばれます。最初の報告者の名前からバージャー病（英語読み）、あるいはビュルガー病（ドイツ語読み）とも呼ばれています。

　患者数は、国内で約1万人と推計されています。男女比は10対1と男性が多く、20～40歳を中心に青・壮年に多く発症します。動脈硬化によって下肢の動脈が詰まる閉塞性動脈硬化症(へいそくせいどうみゃくこうかしょう)も同じような症状を来しますが、閉塞性動脈硬化症は高齢者に多く、40歳以下の若年者にはほとんど発症しません。

　特定疾患であり、医療費は公費負担助成の対象です。