Thromboangiitis Obliterans: Occurrence in a Brother and a Sister

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THROMBOANGIITIS obliterans has been observed in sisters,1–8 in brothers,9,10 and in father and son,11 but to our knowledge this report is the first of its occurrence in brother and sister. In early adult life, both had symptoms and signs of peripheral vascular disease. The clinical findings were typical of thromboangiitis obliterans.


Case 1. A 30 year old man of Bohemian descent was examined in April 1942 because of a three-year history of recurrent ulcer of the toe and intermittent claudication at the level of the calf. Examination revealed color and temperature changes in both feet. There was an ulcer on the great toe of the right foot. The pulses of the feet were absent bilaterally. There was no evidence of diabetes. The patient had been smoking approximately 30 cigarettes per day for 12 years. He stopped smoking, was placed on conservative management, and obtained relief of symptoms.

Following this observation, the patient was seen on live separate occasions over a 12-year period because of exacerbations of the vascular disease. These are briefly outlined below. Each recurrence was preceded by a period of smoking, although he had been repeatedly warned not to smoke.

Twenty-one months after first examination (January 1944) the patient returned because of pain and swelling of the middle finger of the right hand. Oscillometric readings at the wrist level were reduced. A subungual abscess was incised and drained, and again the patient's symptoms subsided with conservative treatment.

He was next seen in December 1948, approximately . . .



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