THROMBOANGIITIS-OBLITERANS WITH INAUGURAL RHEUMATIC MANIFESTATIONS - A REPORT OF 3 CASES

Thromboangiitis obliterans, or Buerger's disease, is a segmental occlu sive inflammatory disorder of the small- and medium-sized arteries and veins seen in young adults and associated with cigarette smoking, The lesions are most marked in the distal limbs, We report three cases in which the first manifestations were rheumatic, consisting in polyarth ritis in two cases and carpal tunnel syndrome in one, Rheumatic manife stations are infrequent and rarely inaugural in thromboangiitis oblite rans, although they are probably underdiagnosed, Their pathogenesis is unclear but may involve autoimmunity, Heightened awareness of the pos sibility that rheumatic manifestations can inaugurate thromboangiitis obliterans may allow an earlier diagnosis of this disease, which may i mprove the functional prognosis, However, recovery can be achieved onl y if the patient stops smoking.