SHM Converge Scientific Abstract ePoster Gallery-One Diagnosis Does Not Rule Out Another

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This case highlights an unusual presentation of thromboangiitis obliterans (Buerger’s disease) causing secondary Raynaud phenomenon. A 35-year-old man who used cannabis and had recently started tobacco presented in summer with bilateral finger pain, numbness, episodic color changes from black to white, and severe cold sensitivity. He developed digital ulcers affecting multiple fingers.<br /><br />Diagnostic testing showed critical small-vessel disease in upper-extremity digits 2, 4, and 5 bilaterally, while lower-extremity studies were normal. Autoimmune testing was largely negative, and the clinical picture fit Buerger’s disease based on age under 50, recent tobacco exposure, distal ischemia, and lack of another clear cause.<br /><br />The case was atypical in several ways. Buerger’s disease usually involves both small and medium vessels and often affects the lower extremities, but this patient had only upper-extremity digital involvement. His Raynaud-like symptoms were also unusual because they occurred in summer, involved digits 2, 4, and 5, and were accompanied by ulceration, which is not typical for primary Raynaud phenomenon.<br /><br />The report emphasizes three main points: thromboangiitis obliterans can lead to secondary Raynaud phenomenon; vasculopathies may present with variable and atypical features; and clinicians should consider the relationship between overlapping disease processes to avoid anchoring on a single diagnosis.<br /><br />Overall, the case underscores the importance of recognizing uncommon presentations of vascular disease, especially in patients with tobacco exposure and distal ischemic symptoms.

Asset Subtitle

Yuliia Varava

Meta Tag

Author List Julie Yi, Sami Tahhan, Samuel Stephenson, Tyler Nguyen, Yuliia Varava

Category Clinical Vignettes

Concept Thromboangiitis Obliterans

Concept Buerger Disease Diagnostic Criteria

Concept Raynaud Disease

Concept Digital Ischemia

Concept Tobacco Use

Distinguished Non-Finalist

Presenter Organization Evms

Presenting Author Yuliia Varava

Track Adult

Keywords

thromboangiitis obliterans

Buerger disease

secondary Raynaud phenomenon

digital ulcers

distal ischemia

tobacco exposure

cannabis use

small-vessel disease

upper extremity digits

vascular disease

Thromboangiitis Obliterans

Buerger Disease Diagnostic Criteria

Raynaud Disease

Digital Ischemia

Tobacco Use