Asia Pacific Journal of Pediatric and Child Health

Abstract Ref Number = APCP748

Poster Presentation

SIXTEEN YEARS GIRL WITH TROMBOANGIITIS OBLITERANS

Pretyca Yudra Perdana,Herlina Dimiati Syiah Kuala university Syiah Kuala University

Background : Thromboangiitis obliterans (TAO) or Buerger’s disease is an inflammatory obliterative, nonatherosclerotic and vascular disease that affect the small and medium sized arteries, veins and nerves. A few observations suggest the existence of an immunologic phenomenon leading to vasodysfunction and inflammatory thrombi. A heart echocardiogram may be done to look for sources of blood clots. Case Presentation Summary : A Sixteen years old girl came to zainoel Abidin hospital with chief complaint necrotic at her superior extremity fingers since 1 month ago. The necrotic fingers still feel pain, and exacerbate by moving. At first the fingers was pale, cyanotic and cold before turning necrotized. No history of smoking and diabetic. In physical examination: vital signs in normal range, no heart murmurs, necrotic at third and fourth fingers, from middle to distal phalang of manus sinistra. Allen test was positive. In laboratory finding hemoglobins 9,6 gr/dl, white blood cells count 15.200/mm3, platelets 533.000/mm3, coagulation factors ( PT, APTT) in normal range, lipid profile in normal range. Anti dsDNA-NcX 127,5 IU/ml, Dopller angiography only able to assest up to radial arteries, CT angiography finding blood flow in manus sinistra is limited to radial and ulnar arteries. The patient was diagnosed as tromboangiitis obliterans. The patient was given analgetic, vasodilator agent, anti platelets, cylostazol and third generation sefalosphorin. The thoracic and cardiovascular surgery division plan to amputate the necrotic fingers. Learning Points/Discussion : Buerger’s disease symptoms include claudication, inflammation along a vein just below the skin’s surface, Raynaud's phenomenon and painful open sores on your fingers and toes. The exact cause of Buerger's disease is unknown. Expert suspect that some people may have a genetic predisposition to the disease. Its also possible that the disease is caused by an autoimmune response in which the body’s immune system mistakenly attacks healthy tissue.

Keywords: Buerger's disease Allen test Raynaud’s phenomenon autoimmune tromboangiitis obliterans