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Correspondence
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Volume 344:230-231 January 18, 2001 Number 3
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Thromboangiitis Obliterans (Buerger's Disease)

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To the Editor: As Olin points out in his review (Sept. 21 issue),1 exposure to tobacco plays a central part in the initiation and progression of thromboangiitis obliterans (Buerger's disease). However, the cause of Buerger's disease remains unknown. Not all patients with the disease smoke or use smokeless tobacco, and in some patients who stop smoking the disease is still progressive. Dr. Olin does not mention hyperhomocysteinemia, which may have an important and nicotine-independent role in the pathogenesis of Buerger's disease. Hyperhomocysteinemia is known to be an important risk factor in the early onset of atherosclerotic occlusive disease and deep-vein . . . [Full Text of this Article]

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