Buerger's disease in a middle-aged woman. A unique presentation

We have presented the 11th probable case of Buerger's disease in a female patient. She had the oldest age of onset of any female patient with this disease yet described. In addition, she was the first female patient who was not actively smoking at the onset of ischemic symptoms. Hence, Buerger's disease should be included in differential diagnosis in any female patient, young or middle-aged, who is an active or former cigarette smoker, has a history of Raynaud's phenomenon, and presents with ischemic disease of the distal extremities. Poor results from attempted revascularization surgery can be anticipated.