Share this page

Health Library

Alpha 1 Anti-Trypsin Deficiency(AAT Deficiency; Alpha-1 Antiprotease Deficiency)

Pronounced: Al-fa-wun An-tee-TRIP-sin Dee-FISH-en-see

Definition

Alpha 1 anti-trypsin (AAT) deficiency is a rare genetic disorder that causes the enzyme AAT to not work well. It can cause lung and liver disease in children and adults.

Causes

AAT deficiency is an inherited disorder. It is passed from parents to children. This condition occurs when the liver does not make useful AAT. AAT is a protein that protects the lungs and other organs from damage. When functional AAT levels are too low, lung damage may occur.

People with AAT deficiency can also develop liver disease. AAT deficiency is one of the major causes of genetic liver disease in children. The liver makes an abnormal version of AAT protein that builds up in the liver. This blockage can damage liver cells. In some cases, severe liver damage can occur.

Risk Factors

If either of your parents have the gene for AAT deficiency, you are at risk of developing problems due to the disease. If both your parents carry the gene, you are at higher risk of having severe problems.

Symptoms

The first symptoms of the disease often appear in adulthood between the ages of 20-50 years:

  • Shortness of breath during mild activity
  • Coughing up sputum (mucus from deep in the lungs)
  • Wheezing
  • Weight loss
  • Lung disease that affects the air sacs
  • Raised red spots on the skin

In addition, if the liver is affected in adults, the following symptoms may be present:

  • Itching
  • Yellowing of the skin and/or whites of the eyes
  • Vomiting
  • Swollen abdomen
  • Abdominal pain

Symptoms in children can occur in the first weeks of life or later in childhood.

  • Infants:
    • Yellowing of the skin and/or whites of the eyes
    • Poor growth and weight gain
    • Foul-smelling stools
    • Swollen abdomen
    • Vomiting
    • Itching
  • Older children:
    • Fatigue
    • Poor appetite
    • Swollen abdomen
Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. You may be referred to a doctor who specializes in the lungs or liver, depending on the symptoms you are having.

Your bodily fluids and tissues may be tested. This can be done with:

  • Blood tests—to examine if AAT levels in the blood are low
  • Genetic testing—to identify the inherited change that causes AAT
  • Liver biopsy —a small piece of the liver is removed and examined for inflammation or scarring

Images may be taken of your lungs. This can be done with a chest x-ray.

Liver Biopsy

Placement of Liver Biopsy Needle

Copyright © Nucleus Medical Media, Inc.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Treatment for Lung Disease
Medications

You may be prescribed medications to boost the levels of AAT. These may be given weekly through an IV in your arm. If you have emphysema, your doctor may treat you with inhaled steroids and other medications to improve your breathing.

Smoking Cessation

If you smoke, your doctor will work with on ways to quit. Smoking can increase the damage to your lungs.

Treatment for Liver Damage

There is no specific treatment for liver disease due to AAT deficiency. Treatment focuses on symptoms and preventing complications. Treatment may include:

  • Vitamin supplements, such as E , D , and K
  • Medications to reduce itching and jaundice
  • Rarely, a liver transplant
Prevention

You cannot prevent AAT deficiency if you have inherited the condition. If you have AAT deficiency, you can reduce your chance of emphysema:

  • Quit smoking
  • Avoid exposure to secondhand smoke
  • Avoid exposure to air pollution or irritants
  • Wear protective gear if exposed to irritants or toxins at work

RESOURCES:

Alpha-1 Association
http://www.alpha1.org

American Lung Association
http://www.lung.org

CANADIAN RESOURCES:

Canadian Liver Foundation
http://www.liver.ca

The Lung Association
http://www.lung.ca

References:

Alpha-1 antitrypsin deficiency. National Jewish Health website. Available at: http://www.nationaljewish.org/healthinfo/conditions/alpha-1. Accessed March 9, 2016.

Alpha-1 antitrypsin deficiency. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/pulmonary_disorders/chronic_obstructive_pulmonary_disease_and_related_disorders/alpha-1_antitrypsin_deficiency.html. Accessed June 2014. Accessed March 9, 2016.

Alpha-1 anti-trypsin deficiency (AAT). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 5, 2015. Accessed March 9, 2016.

COPD. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 10, 2016. Accessed March 9, 2016.

Hericks AJ. An overview of alpha-1 antitrypsin deficiency. Mo Med. 2007;104(3): 255-259.



Last reviewed March 2016 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Baptist Flame

Baptist Health Systems

1-800-948-6262

Find A Doctor

Services

Locations

Baptist Medical Clinic

Patients & Visitors

Learn

Contact Us

Physician Tools

Careers at Baptist

Employee Links

Online Services

At Baptist Health Systems

At Baptist Medical Center

close ×