血栓闭塞性脉管炎(TAO),或者Buerger的病,是一种中小动脉的非动脉粥样硬化性炎症性疾病,静脉,腿和手臂的神经,与年轻人使用烟草制品密切相关。大麻动脉炎(CA),具有相似临床和病理特征的实体,在大麻使用者中被描述为TAO的亚型。区分TAO和CA是具有挑战性的,考虑到大多数患者同时使用烟草和大麻产品。在这里,我们报道了一名四十多岁的男性,他被转诊到风湿病科,有2个月的手部肿胀和双侧疼痛性数字溃疡,手指和脚趾呈蓝色变色。患者报告每天在钝的包裹中使用大麻,并否认使用烟草。他的实验室检查对硬皮病和其他结缔组织疾病呈阴性。他的血管造影证实了血栓闭塞性脉管炎的诊断,这归因于大麻动脉炎。患者每天开始服用阿司匹林和硝苯地平,并停止使用大麻。他的症状在6个月内缓解,并且在继续避免使用大麻的情况下,超过一年没有复发。我们的案例是少数主要以大麻驱动的CA为特征的案例之一,并且突出了不仅要考虑使用大麻的重要性,而且随着全球大麻使用量的增加,在出现雷诺现象和溃疡的患者中也要使用钝器。
Thromboangiitis obliterans (TAO), or Buerger\'s disease, is a non-atherosclerotic inflammatory disease of the small and medium-sized arteries, veins, and nerves of the legs and arms, strongly associated with the use of tobacco products in young adults. Cannabis
arteritis (CA), an entity with similar clinical and pathological features, has been described in marijuana users as a subtype of TAO. Distinction between TAO and CA is challenging, given that most patients use tobacco and marijuana products concomitantly. Herein, we report the
case of a male in his late forties who was referred to rheumatology with a 2-month history of hand swelling and bilateral painful digital ulcers with blue discoloration on his fingers and toes. The patient reported daily use of marijuana in blunt wraps and denied tobacco use. His laboratory work-up was negative for scleroderma and other connective tissue diseases. His angiogram confirmed the diagnosis of thromboangiitis obliterans, which was attributed to cannabis
arteritis. The patient was started on aspirin and nifedipine daily and discontinued marijuana use. His symptoms resolved within 6 months and have not recurred for more than a year with continued avoidance of marijuana. Our
case is one of the few that features primarily marijuana-driven CA and highlights the importance of not only considering marijuana use but also blunt wrap use in patients presenting with Raynaud\'s phenomenon and ulcerations as cannabis use rises globally.