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Published on: February 8, 2019
Buerger's disease: clinical and histomorphological study.
A R Subhashree1, Rama Gopalan, K Baba Krishnan
1Department of Pathology, Dr. A.L.M.P.G.I.B.M.S., University of Madras, Taramani, Chennai 600113.
Indian Journal of Pathology & Microbiology
|December 23, 2006
Summary
Buerger's disease (BD), prevalent in India among beedi smokers, shows distinct clinical and histopathological features. This study highlights consistent findings like thrombus formation and inflammation, with medial hypertrophy and calcification noted as additional characteristics.
Area of Science:
- Vascular Pathology
- Histopathology
- Clinical Medicine
Background:
- Thromboangiitis Obliterans (TAO), or Buerger's disease (BD), has a high prevalence in India, particularly among socioeconomic groups who smoke beedis.
- Understanding the clinical and histopathological characteristics of BD is crucial for diagnosis and management in this population.
Purpose of the Study:
- To investigate the clinical and histo-morphological aspects of Buerger's disease.
- To correlate these findings with the age at presentation in the local Indian population.
Main Methods:
- A study of 25 male beedi smokers clinically diagnosed with BD using Shionoya's criteria.
- Histopathological analysis of 21 biopsies, 2 end-arterectomies, and 2 amputations using H&E and Verhoeff's elastic stains.
- Evaluation of clinical symptoms including claudication, infrapopliteal/upper limb involvement, and migratory thrombophlebitis.
Main Results:
- Consistent histopathological features included thrombus (with or without recanalization), inflammatory cell infiltrate, subintimal/medial fibrosis, and internal elastic lamina changes.
- Additional observed features were medial hypertrophy and calcification.
- Clinical presentation involved claudication, significant infrapopliteal disease (24 cases), and upper limb involvement (9 cases).
Conclusions:
- The study confirms key histopathological features of Buerger's disease, consistent with existing literature.
- Medial hypertrophy and calcification are identified as notable additional features in this cohort.
- Clinical and histopathological correlation aids in understanding BD in the context of local risk factors like beedi smoking.
