Jiménez-Paredes C A, Cañas-Dávila C A, Sanchez A, Restrepo J F, Peña M, Iglesias-Gamarra A
Internal Medicine Department, Medical School, National University of Colombia, San Juan de Dios Hospital, Santa Fe de Bogota.
Int J Cardiol. 1998 Oct 1;66 Suppl 1:S267-72. doi: 10.1016/s0167-5273(98)00178-8.
To know the clinical characteristics in the presentation of Buerger's disease in San Juan de Dios Hospital, Bogota, Colombia, between 1986 and 1996, and compare them with a previous series from the same Hospital and another reported in international literature; To determine the changes in the form of appearance of the disease.
We reviewed the clinical information of 22 patients with diagnosis of Buerger's disease, observed between 1986 and 1993, and we added the information of the clinical histories of eight other patients with equal diagnosis, observed between 1994 and 1996 in our Unit.
We observed 30 patients: 28 men (93%) and two women (7%), with a ratio M:F of 14:1, with an average age of 39+10 years (range from 18 to 52 years). Sixty percent were younger than 40 years and only the 10% were older than 50 years. The most frequent reasons for consultation were: pain in rest in the affected extremity, gangrene and ulceration in more than 50%. Raynaud's phenomenon in 30%, and the related surgical history in 40%. The pedal pulse was the most compromised followed by popliteal, poster or tibial and femoral. We did not observe the presence of thrombophlebitis. Eighty percent showed compromise of more than one extremity. All of them were active smokers. Three patients showed IgG anticardiolipine antibodies at high level.
The clinical characteristics are similar to those reported, we find also a reduction of the disease diagnosis. It calls to our attention that no thrombophlebitis was found in the present series and the less compromise of the upper extremities with a frequent femoral compromise. All this points toward a change in the natural history of the disease.
了解1986年至1996年期间,哥伦比亚波哥大圣胡安·迪奥斯医院布加综合征的临床特征,并将其与该医院之前的系列病例以及国际文献中报道的另一组病例进行比较;确定该疾病表现形式的变化。
我们回顾了1986年至1993年期间诊断为布加综合征的22例患者的临床信息,并补充了1994年至1996年在我们科室观察到的另外8例诊断相同患者的临床病史信息。
我们观察了30例患者:28例男性(93%)和2例女性(7%),男女比例为14:1,平均年龄为39±10岁(范围为18至52岁)。60%的患者年龄小于40岁,只有10%的患者年龄大于50岁。最常见的就诊原因是:受累肢体静息痛、超过50%的患者出现坏疽和溃疡。30%的患者出现雷诺现象,40%的患者有相关手术史。足背动脉受累最严重,其次是腘动脉、胫后动脉和股动脉。我们未观察到血栓性静脉炎的存在。80%的患者有一个以上肢体受累。所有患者均为现吸烟者。3例患者显示高水平的IgG抗心磷脂抗体。
临床特征与报道的相似,我们还发现疾病诊断有所减少。本系列中未发现血栓性静脉炎,上肢受累较少且股动脉受累频繁,这引起了我们的注意。所有这些都表明该疾病的自然史发生了变化。