Pulmonary disease in idiopathic urticarial vasculitis.

A 45-year-old woman developed chronic urticaria clinically and cutaneous necrotizing vasculitis histologically, with arthralgias, abdominal pain, angioedema, hemoptysis, and pleuritic chest pain. An open lung biopsy revealed a leukocytoclastic vasculitis of the pulmonary venules, which may be etiologically associated with the chronic obstructive lung disease detected in this patient by pulmonary function tests. The documentation of pulmonary disease in patients with urticarial vasculitis emphasizes the potentially serious nature of this disorder and the need for careful diagnosis and prompt, vigorous treatment.