Alpha₁-Antitrypsin Deficiency in Chronic Obstructive Pulmonary Disease

Excerpt

Is alpha₁-antitrypsin deficiency an etiologic culprit or an innocent genetic bystander in chronic obstructive pulmonary disease? Any consideration of the cause of chronic obstructive pulmonary disease (chronic bronchitis and emphysema) must deal with the variation in clinical and pathological features within this closely interrelated group of illnesses. At one end of the spectrum of clinical pictures is the so-called type A or emphysematous patient (1, 2), typically a thin man who suffers for several years from slowly progressive dyspnea without much cough or sputum production. The lungs are large and radiologically hyperlucent. Despite the severity and chronicity of the dyspnea,