Med. J. Cairo Univ., Vol. 60, No. 1: 87 - 95 , 1992
Alpha-One Antitrypsin Phenotypes in Chest
Diseases in Infants and Children
ZINAB RADWAN, M. D.; SAMIHA SAMUEL, M.D.;
NERMIN BAHGAT, M.D.; IBRAHIM RADWAN, M.D.;
MOHAMED HANI HAFEZ, M.D. and MOHAMED SABRY
SALIM, M.D.
The Pediatric, Chemical Pathology, Internal Medicine and Chest
Departments, Faculties of Medicine, Cairo, Al-Azhar and Banha Universities
Abstract
Most of the previous studies were done on Ihe relation between alphal-
anlilrypsin (ALAT) and pulmonary diseases in adulthood. In the present
work, we studied 91 infants and children (52 males and 40 females)
suffering from 5 common chest diseases : Chronic bronchitis (25 patients),
bronchieclasis (12 patients), bronchial asthma (20 patients),
bronchopneumonia (15 patients) and pulmonary TB (20 patients).
Bronchial asthma patients were subdivided into atopic (14 cases) and non
atopic (6 cases) according to the results of IgE and allergic skin test. 30
normal children were taken as controls. All patients and controls were
subjected to chest radiographs, CBCt ESR, quantitative determination of
scrum ALAT by radial immunodillusion method and ALAT phenotyping by
immunofixation eleclrophoresis. A second serum ALAT determination
alter 3 weeks of treatment was carried in chronic bronchitis,
bronchopneumonia and bronchial asthma groups. It was done after 6
months in tuberculous patients. Serum ALAT in all patient groups, with
the exception of bronchial asthma, was significantly higher than control at
the initial estimation. As ALAT is one of the acute phase reactants it rises in
active chest diseases. After treatment these high levels dropped to normal.
In asthmatic patients, there is significant decrease of serum ALAT, both in
atopic and non atopic cases. But the level was higher in patients with
associated chest infection than in those without. As regards ALAT
phenotyping the MM phenotype was the commonest. It was found in all
controls, in 84% of chronic bronchitis, 75% of bronchiectasis, 86.6% of
bronchopneumonia, 85% of TB. In asthmatics other Pi variants (MS, M/.,
SS), known to be ALAT deficient formed the majority of cases. Among the
92 patients studied, 22.23% had other phenotype variants than the PiM.
These PiM were heterozygous deficient in ALAT and presented as recurrent
chest infections or bronchial asthma.
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