O'Dell J R, Linder J, Markin R S, Moore G F
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68105.
Arthritis Rheum. 1987 Sep;30(9):1054-6. doi: 10.1002/art.1780300913.
Thromboangiitis obliterans, a distinct clinical and pathologic entity characterized by segmental inflammatory and proliferative lesions of the tunica media of small arteries and veins, has been reported frequently in men who have a history of heavy cigarette smoking. We report a case of thromboangiitis obliterans in a 38-year-old man that was clearly associated with the use of smokeless (chewing) tobacco. In addition to a physical history and examination and laboratory evaluation, a biopsy of the skin and deep subcutaneous tissue of the patient's left thigh was performed, and this revealed occlusion of 2 large dermal blood vessels by a highly organized thrombus. A regimen of nifedipine and antiplatelet therapy, plus complete abstinence from tobacco, resulted in resolution of the patient's symptoms and pain. Our findings may be of particular importance in view of the increasing popularity of smokeless tobacco and the complications which may result from its use.
血栓闭塞性脉管炎是一种独特的临床和病理实体，其特征为小动脉和小静脉中膜的节段性炎症和增生性病变，经常在有大量吸烟史的男性中报道。我们报告一例38岁男性的血栓闭塞性脉管炎病例，该病例明确与使用无烟（咀嚼）烟草有关。除了病史、体格检查和实验室评估外，还对患者左大腿的皮肤和深部皮下组织进行了活检，结果显示2条大的真皮血管被高度组织化的血栓阻塞。硝苯地平和抗血小板治疗方案，加上完全戒烟，使患者的症状和疼痛得到缓解。鉴于无烟烟草越来越受欢迎以及使用它可能导致的并发症，我们的发现可能具有特别重要的意义。
