A case of precocious emphysema and lung cancer in a woman with a history of hypocomplementemic urticarial vasculitis.
Severe emphysema developed in a white woman with a 26-pack-year history of tobacco use. Serum alpha(1)-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.
Jamison
Suzanna C
SC
Carilion Health Systems, PO Box 13667, Roanoke, VA 24033, USA. sjamison@carilion.com
Brierre
Stephen
S
Sweet
Jon
J
de Boisblanc
Ben
B
D000280:Administration, Inhalation; D000284:Administration, Oral; D000328:Adult; D001993:Bronchodilator Agents / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000175:diagnosis; D003165:Complement System Proteins / Q000172:deficiency*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000175:diagnosis; D011241:Prednisone / Q000008:administration & dosage; D011656:Pulmonary Emphysema / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014581:Urticaria / Q000097:blood / Q000150:complications*; D014657:Vasculitis / Q000097:blood / Q000150:complications*
D001993:Bronchodilator Agents; D005938:Glucocorticoids; D003165:Complement System Proteins; D011241:Prednisone