Decrease in prevalence of Buerger's disease in Japan

Abstract

Background: Buerger's disease is a peripheral arterial occlusive disease that is becoming rare in Western countries but is more common in Asia. Whether it is a specific disease entity remains controversial. This study was undertaken to investigate changes in the prevalence and characteristics of Buerger's disease at a major institution in Japan. Methods: Patients with Buerger's disease admitted to Nagoya University Hospital between January 1985 and December 1996 were studied retrospectively. Buerger's disease was diagnosed on admission according to Shionoya's clinical criteria. Results: A total of 105 patients with Buerger's disease were evaluated on 126 admissions; 58 were new patients who were admitted for initial treatment, and 47 patients were experiencing a worsening of Buerger's disease and had a history of prior treatment. Forty-six new patients were admitted between 1985 and 1989, but only 12 new patients were admitted between 1990 and 1996 (9 ± 3/yr vs 2 ± 2/yr, p = 0.0003). Between 1985 and 1989, 44 patients were admitted because of disease exacerbation, whereas only 24 such admissions occurred between 1990 and 1996 (9 ± 3/yr vs 3 ± 3/yr, p = 0.0137). The number of admissions for atherosclerotic peripheral vascular disease did not change significantly in that period. Of the 105 patients, the majority (96%) were men; mean age at the time of disease onset was 36 ± 8 years. The chief complaint on admission was gangrene/ulcer in 64%, rest pain in 13%, foot claudication in 6%, calf claudication in 6%, and others in 10%. Conclusions: The prevalence of Buerger's disease appears to be decreasing at our institution in Japan. Its clinical characteristics have not changed. A similar decrease in prevalence appears to have occurred in Western countries. (Surgery 1998;124:498-502.)