Thrombo-angiitis obliterans (Buerger’s Disease):

Thrombo-angiitis obliterans (Buerger’s Disease): 

Thrombo-angiitis obliterans (TAO), also known as Buerger's disease, is a rare autoimmune disorder that affects the blood vessels of the arms and legs. It causes inflammation and clotting in the blood vessels, which can lead to a blockage of blood flow to the affected limb. This results in pain, numbness, and tissue damage. TAO typically affects young men who smoke, but it can also affect women and non-smokers.


The exact cause of TAO is not known, but it is believed to be an autoimmune disorder, where the body's immune system mistakenly attacks its own blood vessels. Other potential causes and risk factors include:

  • Smoking: Smoking is the most common risk factor for TAO, as it can damage the lining of blood vessels and trigger an immune response.
  • Genetics: TAO may have a genetic component, as it is more common in people of Asian and Middle Eastern descent.
  • Infection: Certain infections, such as gum disease, may trigger an immune response that can lead to TAO.


The symptoms of TAO can vary depending on the severity of the condition. Some common symptoms include:

  • Pain and tenderness in the arms or legs, particularly during exercise.
  • Numbness or tingling in the arms or legs.
  • Pale, cold, or blue skin in the affected limb.
  • Weak or absent pulses in the affected limb.
  • Ulcers or sores on the fingers or toes.
  • Gangrene, or tissue death, in severe cases.


Diagnosing TAO typically involves a physical exam and imaging tests to evaluate blood flow in the affected limb. The tests may include:

  • Doppler ultrasound: This test uses sound waves to create images of blood flow in the affected limb.
  • Angiography: This test involves injecting a contrast dye into the blood vessels and taking X-rays to create detailed images of the blood vessels in the affected limb.
  • Magnetic resonance angiography (MRA): This imaging test uses a magnetic field and radio waves to create detailed images of the blood vessels in the affected limb.
  • Blood tests: Blood tests can help rule out other conditions with similar symptoms, such as rheumatoid arthritis or lupus.

Note 1: The ankle/brachial index is the ratio of the systolic blood pressure at the ankle (determined by Doppler study) divided by the simultaneous brachial artery systolic blood pressure. The normal index is 1.0 or greater.


Note 2: These evaluations are for involvement of a single extremity. If more than one extremity is affected, evaluate each extremity separately and combine (under §4.25), using the bilateral factor (§4.26), if applicable.

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