Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2015, vol. 24, nr 6, November-December, p. 1085–1097

doi: 10.17219/acem/33322

Publication type: review

Language: English

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The Pathogenesis and Diagnosis of Thromboangiitis obliterans: Is It Still a Mystery?

Rafał Małecki1,A,B,C,D, Joanna Kluz1,A,B,C, Joanna Przeździecka-Dołyk2,3,E,F, Rajmund Adamiec1,E,F

1 Department of Angiology, Hypertension and Diabetology, Wroclaw Medical University, Poland

2 Department and Clinic of Ophthalmology, Wroclaw Medical University, Poland

3 Department of Vascular, General and Transplantation Surgery, Wroclaw Medical University, Poland

Abstract

Thromboangiitis obliterans (TAO) is a rare disease of unknown etiology that results in the occlusion of limb arteries located distally to the elbow and knee. Despite the fact that more than one hundred years have passed since its first description, knowledge on the pathogenesis of TAO and precipitating factors is still limited. Due to a lack of decisive noninvasive diagnostic methods and geographical differences in the prevalence of this condition, data on TAO epidemiology also remains sparse. This review presents important evidence on the pathogenesis and the course of the condition, as well as diagnostic modalities, with a focus on differential diagnosis. Theories on the pathogenesis of TAO include the theory of an infectious disease, coagulation disorders and injury to vascular endothelium resulting in activation of the inflammatory response. Differential diagnosis should exclude thoracic outlet syndrome, blue toe syndrome, infectious endocarditis, popliteal entrapment syndrome, Takayasu disease, primary and secondary systemic vasculitis, antiphospholipid syndrome, infection with the anaerobic Clostridium sp. bacilli and some less common conditions.

Key words

differential diagnosis, thromboangiitis obliterans, Buerger’s disease, angiology

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