Introduction: Thromboangeitis obliterans (TAO) is an inflammatory, non atheromatous arteriopathy of smoking young adults. It is diagnosed on an association of non specific criteria that we discuss throughout this case.
Case report and discussion: A forty years old tabagical, Senegalese black man, had peripheral destructive lesions preceded by Raynaud phenomenon. He was admitted in our Internal Medicine department in November 2002. Actually this clinical presentation was evolving since 11 years. At that time, hypo aesthesia and ulceration of the fingers led to successive amputations in the leprology centre. The diagnosis of Hansen disease had been suspected but there were no evidence of mycobacterium. At the admission in our service, biological tests showed a moderated non-specific inflammatory syndrome. Ultra sound Doppler and arteriography showed a peripheral arterial stenosis without atheromatous lesions, in favour of TAO. To meet all the criteria the patient didn't have any thrombotic or systemic disease. The evolution was favourable after tobacco weaning.
Conclusion: TAO can bring to difficulties of diagnosis by its way of presentation. Physicians should practice a systematic vascular screening in case of distal arteriopathy.