A challenging diagnosis of alpha-1-antitrypsin deficiency: Identification of a patient with a novel F/Null phenotype

Michael R. Ringenbach, Erin Banta, Melissa R. Snyder, Timothy J. Craig, Faoud T. Ishmael

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Abstract

Alpha-1-antitrypsin (A1AT) deficiency is a genetic disease characterized by low levels and/or function of A1AT protein. A1AT deficiency can result in the development of COPD, liver disease, and certain skin conditions. The disease can be diagnosed by demonstrating a low level of A1AT protein and genotype screening for S and Z mutations, which are the most common. However, there are many genetic variants in A1AT deficiency, and this screening may miss rarer cases, such as those caused by dysfunctional protein. We identified a patient with a previously unreported F/null phenotype that was missed by routine screening. This case highlights the wide variation in possible mutations, limitations in diagnostics, and the importance of combining clinical suspicion with measurement of protein levels, phenotypic analysis, and in appropriate cases expanded genetic analysis.

Original languageEnglish (US)
Article number18
JournalAllergy, Asthma and Clinical Immunology
Volume7
Issue number1
DOIs
Publication statusPublished - Nov 13 2011

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All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine

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