Berger's disease

Berger's disease is a rare disease of the arteries and veins in the arms and legs. In Berger's disease also called thromboangiitis obliterans

1. Berger's disease

2. INTRODUCTION Berger's disease is a rare disease of the arteries and veins in the arms and legs. In Berger's disease also called thromboangiitis obliterans ( TAO) your blood vessels become inflamed, swell and can become blocked with blood clots (thrombi). This eventually damages or destroys skin tissues and may lead to infection and gangrene. Berger's disease usually first shows in your hands and feet and may eventually affect larger areas of your arms and legs

3. Symptoms Berger's disease symptoms include: Tingling or numbness in the hands or feet. Pale, reddish or blue-tinted hands or feet. Pain that may come and go in your legs and feet or in your arms and hands. This pain may occur when you use your hands or feet and eases when you stop that activity (claudication), or when you're at rest. Inflammation along a vein just below the skin's surface (due to a blood clot in the vein). Fingers and toes that turn pale when exposed to cold (Raynaud's phenomenon). Painful open sores on your fingers and toes

4. Causes The exact cause of Berger's disease is unknown. While tobacco use clearly plays a role in the development of Berger's disease, it's not clear how it does so. It's thought that chemicals in tobacco may irritate the lining of your blood vessels, causing them to swell. Experts suspect that some people may have a genetic predisposition to the disease. It's also possible that the disease is caused by an autoimmune response in which the body's immune system mistakenly attacks healthy tissue.

5. Risk factors Tobacco use Cigarette smoking greatly increases your risk of Berger's disease. But Berger's disease can occur in people who use any form of tobacco, including cigars and chewing tobacco. People who smoke hand-rolled cigarettes using raw tobacco and those who smoke more than a pack and half of cigarettes a day may have the greatest risk of Berger's disease. The rates of Berger's disease are highest in areas of the Mediterranean, Middle East and Asia where heavy smoking is most common.

6. Chronic gum disease Long-term infection of the gums has been linked to the development of Berger's disease, though the reason for this connection isn't yet clear. Sex Berger's disease is far more common in males than in females. However, this difference may be linked to higher rates of smoking in men. Age The disease often first appears in people less than 45 years old .

7. Complications If Berger's disease worsens, blood flow to your arms and legs decreases. This is due to blockages that make it hard for blood to reach the tips of your fingers and toes. Tissues that don't receive blood don't get the oxygen and nutrients they need to survive. This can cause the skin and tissue on the ends of your fingers and toes to die (gangrene). Signs and symptoms of gangrene include black or blue skin, a loss of feeling in the affected finger or toe, and a foul smell from the affected area. Gangrene is a serious condition that usually requires amputation of the affected finger or toe.

8. Diagnosis Blood tests Blood tests to look for certain substances can rule out other conditions that may cause similar signs and symptoms. For instance, blood tests can help rule out autoimmune diseases such as scleroderma or lupus, blood-clotting disorders, and diabetes. The Allen's test Your doctor may perform a simple test called the Allen's test to check blood flow through the arteries carrying blood to your hands. In the Allen's test, you make a tight fist, which forces the blood out of your hand. Your doctor presses on the arteries at each side of your wrist to slow the flow of blood back into your hand, making your hand lose its normal color. Next, you open your hand and your doctor releases the pressure on one artery, then the other. How quickly the color returns to your hand may give a general indication about the health of your arteries. Slow blood flow into your hand may indicate a problem, such as Berger's disease.

9. Angiogram An angiogram helps to see the condition of your arteries. An angiogram can be done non-invasively with the use of CT or MRI scans. Or it may be done by threading a catheter into an artery. During this procedure, a special dye is injected into the artery, after which you undergo a series of rapid X-rays. The dye helps make any artery blockages easier to see on the images. Your doctor may order angiograms of both your arms and your legs — even if you don't have signs and symptoms of Berger's disease in all of your limbs. Berger's disease almost always affects more than one limb, so even though you may not have signs and symptoms in your other limbs, this test may detect early signs of vessel damage

10. Treatment Smoking cessation Although no treatment can cure Berger's disease, the most effective way to stop the disease from getting worse is to quit using all tobacco products. Even a few cigarettes a day can worsen the disease. Your doctor can counsel you and recommend medications to help you stop smoking and stop the swelling in your blood vessels. You'll need to avoid nicotine replacement products because they supply nicotine, which activates Berger's disease. There are non-nicotine products that you can use. Another option is a residential smoking cessation program. In these programs, you stay at a treatment facility, sometimes a hospital, for a set number of days or weeks. During that time you participate in daily counseling sessions and other activities to help you deal with the cravings for cigarettes and to help you learn to live tobacco-free .

11. Other treatments Other treatment approaches exist for Berger's disease, but are less effective than quitting smoking. Options include: Medications to dilate blood vessels, improve blood flow or dissolve blood clots Intermittent compression of the arms and legs to increase blood flow to your extremities Spinal cord stimulation Amputation, if infection or gangrene occurs

12. Prevention Quit using tobacco in any form here's no vaccine or behavior modification that can prevent a person from developing Berger's disease. However, quitting smoking can prevent progression of the disease. Virtually everyone who has Berger's disease has used tobacco in some form, most prominently cigarettes. To prevent Berger's disease, it's important to not use tobacco

13. Nursing Management Provide for ulcer debridement and healing Remove dead or damaged material from the wound, using wet-to-dry dressing with saline solution and coarse-mesh gauze filled with cotton Consider using an enzymatic debrided to aid removal of debris. Provide additional intervention to promote venous return and healing, maximize comfort and provide client education for measures to prevent venous stasis ulcer. Administer medications which may include antibiotics. The patient is encouraged to make the lifestyle changes necessitated by the onset of a chronic disease, including pain management and modifications in diet, activity, and hygiene (skin care). The nurse assists the patient in developing and implementing a plan to stop using tobacco.

14. the end B y – Nitin sharma