Author(s): Sauvanier M, Constans J, Skopinski S, Barcat D, Berard A, , Sauvanier M, Constans J, Skopinski S, Barcat D, Berard A,
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Abstract OBJECTIVES: Juvenile peripheral obstructive arterial diseases (POAD) have been poorly investigated but account for 1 to 7\% of POAD. We analyzed retrospectively a cohort of patients with onset before the age of 50 years. PATIENTS AND METHODS: Seventy-three patients (60 males and 13 females) were divided into 4 groups (Buerger's disease: TAO, atheromatous PAOD, auto-immune POAD, arteriopathy of undetermined origin). RESULTS: The first symptoms occurred at 38 +/- 8 years of age. Fourteen patients (20\%) had TAO, 51 (70\%) atheromatous POAD, 4 (5\%) POAD with systemic or autoimmune disease, and 4 (5\%) undetermined POAD. Age of onset was earlier in TAO (35 +/- 8 vs 40 +/- 8 years, p=0.046), smoking greater in the atheroma group (33 +/- 16 vs 24 +/- 14 pack-years, p=0.033). Fifty-three POAD patients had dyslipidaemia and 26\% hypertension. Regular cannabis intake was more frequent in the TAO group (21 vs 8\%). At the time of medical care, Fontaine's stage was more frequently stage II in atheroma patients (57 vs 14\%) and stage IV in TAO patients (86 vs 35\%). TAO was diagnosed in 43\% cannabis users and in 19\% non users. CONCLUSION: The main etiology of juvenile POAD is atheroma, followed by TAO. Cannabis users account for at least 10\% of these patients. They are characterized by lower tobacco intake, more distal lesions, more frequent involvement of the upper limbs. They present more frequently as TAO.
This article was published in J Mal Vasc
and referenced in Journal of Clinical & Experimental Dermatology Research