A Case of Precocious Emphysema and Lung Cancer in a Woman With a History of Hypocomplementemic Urticarial Vasculitis*

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Abstract

Severe emphysema developed in a white woman with a 26–pack-year history of tobacco use. Serum α1-antitrypsin levels were normal. A history of autoimmune hemolytic anemia, angioedema, low complement, and recurrent urticaria prompted an immunologic workup that ultimately led to a diagnosis of hypocomplementemic urticarial vasculitis syndrome. Treatment with oral prednisone and inhaled bronchodilators improved symptoms, but 4 months after diagnosis non-small cell lung cancer was discovered and she ultimately died. Hypocomplementemic urticarial vasculitis is an uncommon cause of precocious emphysema and has not previously been reported in a patient with bronchogenic carcinoma.

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