The Rare Case of Thromboangiitis Obliterans in a Patient Previously Diagnosed with a Stroke

The Rare Case of Thromboangiitis Obliterans in a Patient Previously Diagnosed with a Stroke

Niki Parikh and Franklyn Babb

Texas Tech University Health Sciences Center, Department of Family Medicine, 3601 4th Street, STOP 8312, Lubbock, TX 79430-8312

Thromboangiitis obliterans (Buerger’s disease) is a disease of small and medium-sized vasculature, mainly involving the distal upper and lower extremities in male patients under the age of 45. Smoking tobacco is considered to be a predisposing and triggering agent. This presentation discusses the case of JS, a 35-year old male patient who initially presented with a stroke, followed by pain and swelling in the upper extremity, and finally with pain, absent peripheral pulses, and necrosis of the left lower extremity requiring below knee amputation. This case is of interest due to the rarity of this disease in the developed world, the presentation of a stroke in a young patient later diagnosed with thromboangiitis obliterans, and the use of a prostaglandin analog in treatment. This case highlights the difficulty of making the diagnosis of vasculitis and the time consuming, multispecialty approach that is required. The availability of subspecialists, medical record integration, communication between community hospitals, and the drug Iloprost could have positively affected the patient’s outcomes and prognosis.

Keywords: thromboangiitis obliterans, buerger, winiwarter-buerger, iloprost, smoking

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How to cite this article:

Niki Parikh and Franklyn Babb. The Rare Case of Thromboangiitis Obliterans in a Patient Previously Diagnosed with a Stroke. International Journal of Case Reports, 2019 4:71. DOI: 10.28933/ijcr-2019-03-1005

References:

1 Zerbino DD, Zimba EA, Bagry NN. [Thromboangiitis obliterans (Buerger’s disease): state of the art]. Angiol Sosud Khir. 2016; 22: 185-92.
2 Aqel M, Olin J. Thromboangiitis Obliterans (Buerger’s Disease). Sage Journals. 1997; 2.
3 Buerger’s Disease. Rare Disease Database. National Organization for Rare Disorders 2007.
4 Fiessinger JN, Frank M. [THROMBOANGIITIS OBLITERANS (BUERGER’S DISEASE)]. Rev Prat. 2015; 65: 1079-83.
5 Jiménez-Gallo D, Albarrán-Planelles C, Arjona-Aguilera C, Blanco-Sánchez G, Rodríguez-Mateos ME, Linares-Barrios M. Treatment of thromboangiitis obliterans (Buerger’s disease) with high-potency vasodilators. Dermatol Ther. 2015; 28: 135-9.
6 Cacione DG, Macedo CR, Baptista-Silva JC. Pharmacological treatment for Buerger’s disease. Cochrane Database Syst Rev. 2016; 3: CD011033.
7 Fernandez B, Strootman D. The prostacyclin analog, treprostinil sodium, provides symptom relief in severe Buerger’s disease–a case report and review of literature. Angiology. 2006; 57: 99-102.
8 Drake ME. Winiwarter-Buerger disease (‘thromboangiitis obliterans’) with cerebral involvement. JAMA. 1982; 248: 1870-2.
9 Campello Morer I, Capablo Liesa JL, Guelbenzu Morte S, Carod Artal J, López Gastón JI, Ara Callizo JR. [Thromboangiitis obliterans with cerebral involvement]. Neurologia. 1995; 10: 384-6.
10 LIPPMANN HI. Cerebrovascular thrombosis in patients with Buerger’s disease. Circulation. 1952; 5: 680-92.
11 Calgüneri M, Oztürk MA, Ay H, Arsava EM, Altinok D, Ertenli I, et al. Buerger’s disease with multisystem involvement. A case report and a review of the literature. Angiology. 2004; 55: 325-8.