Alpha 1-antitrypsin deficiency in Indian patients with chronic obstructive airways and other pulmonary diseases

OBJECTIVE: To determine alpha 1-antitrypsin (A1AT) deficiency in patients with chronic obstructive airways disease (COAD) and other pulmonary diseases. DESIGN: Observation study. SUBJECTS: 45 patients with COAD, 20 with bronchiectasis, 11 with pulmonary tuberculosis, 25 with chest malignancies and 42 healthy subjects. SETTING: Christian Medical College Hospital, Vellore, India. MAIN OUTCOME MEASURE: Serum A1AT level of 10% or less of the mean serum value of the control group was recognised as severe deficiency and A1AT level between 10 and 60% was considered as intermediate deficiency. RESULTS: 26 patients (18 with COAD, 2 with bronchiectasis, 3 with tuberculosis and 3 with chest malignancies) had intermediate A1AT deficiency. CONCLUSION: The finding of an A1AT deficiency in over a quarter of the patients comprising various categories of pulmonary diseases emphasises the need to explore the possibility of an underlying acquired cause existing either alone or in association with genetic defect in patients showing such a deficiency.