Disdier P, Swiader L, Jouglard J, Piquet P, Christides C, Moulin G, Harlé J R, Weiller P J
Service de Médecine interne, Hôpital de la Timone, Marseolle.
Presse Med. 1999 Jan 16;28(2):71-4.
We observed two cases of juvenile endarteritis which might suggest a possible link between Winiwarter-Buerger disease and cannabis-induced endarteritis.
Our two patients were young men aged 18 and 20 years. Both developed acute distal ischemia of the lower or upper limbs with arteriographic evidence suggestive of Winiwarter-Buerger disease. Both smoked regularly but not excessively and both used cannabis regularly. In one case, the therapeutic response to withdrawal of cannabis was good. In the second, use of cannabis continued and arterial disease persisted.
The cause of Winiwarter-Buerger disease remains elusive although smoking is undoubtedly involved in the pathogenic mechanism. Our two cases recall the cannabis-induced endarteritis described in the sixties in Kif smokers in North Africa. The main clinical and radiographical features in this condition are the same as in Winiwarter-Buerger disease.
Winiwarter-Buerger disease and cannabis-induced endarteritis are 2 very similar conditions. The probably rare finding of juvenile endarteritis mimicking thromboangeitis obliterans should, in our opinion, be considered as a secondary and possibly toxic effect of cannabis.
我们观察到两例青少年动脉内膜炎病例，这可能提示温尼瓦特 - 伯格病与大麻所致动脉内膜炎之间存在潜在联系。
我们的两名患者均为18岁和20岁的年轻男性。两人均出现下肢或上肢急性远端缺血，血管造影证据提示温尼瓦特 - 伯格病。两人均有规律吸烟但不过量，且均有规律使用大麻。其中1例，停用大麻后治疗反应良好。另一例，继续使用大麻且动脉疾病持续存在。
尽管吸烟无疑参与了温尼瓦特 - 伯格病的发病机制，但其病因仍不明确。我们的两例病例让人想起20世纪60年代在北非 kif 吸烟者中描述的大麻所致动脉内膜炎。这种情况的主要临床和影像学特征与温尼瓦特 - 伯格病相同。
温尼瓦特 - 伯格病和大麻所致动脉内膜炎是两种非常相似的病症。我们认为，模仿血栓闭塞性脉管炎的青少年动脉内膜炎这一可能罕见的发现，应被视为大麻的继发性且可能是毒性作用。
