Buerger’s Disease and Hyperhomocysteinemia: Is there a Relationship?

Thromboangiitis obliterans, also known as Buerger’s disease, is a cause of juvenile lower limb ischaemia. Buerger’s disease is idiopathic and one of diagnostic criteria is the absence of atherosclerotic risk factors other than smoking. A possible involvement of thrombophilia has been investigated and the role of hyperhomocysteinemia is still matter of discussion. We describe 9 patients with Buerger’s disease followed-up for the past 3 years. We found a significant increase in circulating homocysteine levels (mean: 31.6 in patients vs 8.2 μmol/L in control subjects). We also analyzed the C677T mutation of MTHFR; 5/9 Buerger’s patients were heterozygotes and 4/9 homozygotes for the mutation as compared with 3 heterozygotes in the control group. Our data, although preliminary, suggest a possible role of homocysteine in the pathogenesis of Buerger’s disease as one of the causes of endothelial dysfunction. The role of MTHFR C677T variant must be further evaluated in larger trials involving patients with Buerger’s disease.