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

Suzanna C. Jamison, MD; Stephen Brierre, MD, FCCP; Jon Sweet, MD; Ben de Boisblanc, MD, FCCP
Author and Funding Information

*From Carilion Health Systems (Drs. Jamison and Sweet), Roanoke, VA; and Louisiana State University (Dr. Brierre), Baton Rouge, LA; and Louisiana State University (Dr. de Boisblanc), New Orleans, LA.

Correspondence to: Suzanna C. Jamison, MD, Carilion Health Systems, PO Box 13667, Roanoke, VA 24033; e-mail: sjamison@carilion.com


Chest. 2008;133(3):787-789. doi:10.1378/chest.07-0942
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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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