[Delayed diagnosis of alpha-1 antitrypsin deficiency]. / Diagnóstico tardío de déficit de α-1-antitripsina.

Alpha-1 antitrypsin deficiency (AAT-D) is a genetic disease, relatively common in populations of European ancestry. AAT-D remains undiagnosed in many patients, and there are often long delays between the onset of respiratory symptoms and diagnosis. AAT-D can be readily diagnosed by measurement of the serum or plasma protein level, which should be confirmed by assessing the genotype or protein phenotype when AAT levels are below the normal range. Close monitoring for the development or progression of lung disease or liver disease is required, and can improve the prognosis. We show the case of a 69 year old woman with recurrent respiratory infections and asthma symptoms. The serum levels of AAT were below the normal range, and ZZ genotype was confirmed. The delayed diagnosis of our patient seems to emphasize the need to remind the doctors about AAT-D, frequently associated with asthma or COPD symptoms.

Diagnóstico tardío de déficit de α-1- antitripsina / Delayed diagnosis of alpha-1 antitrypsin deficiency

El déficit de alfa-1 antitripsina (D-AAT) es una enfermedad genética, relativamente frecuente en poblaciones de origen europeo. Frecuentemente está infradiagnosticada, con largos retrasos entre el inicio de los síntomas respiratorios y el diagnóstico definitivo. El D-AAT puede diagnosticarse con la determinación de los niveles séricos de esta proteína, y, cuando están por debajo del rango normal debe ser confirmado con el fenotipo. El seguimiento correcto de la progresión de la enfermedad debe realizarse en todos los casos, ya que se asocia con mejor pronóstico. Presentamos el caso de una mujer de 69 años, con infecciones respiratorias de repetición y sintomatología asmática. Los niveles de AAT estaban por debajo de la normalidad, confirmándose posteriormente el fenotipo ZZ. El retraso diagnóstico de nuestra paciente parece reforzar la necesidad de alertar a los médicos sobre esta enfermedad, frecuentemente asociada con síntomas de asma o EPOC (AU)

Alpha-1 antitrypsin deficiency (AAT-D) is a genetic disease, relatively common in populations of European ancestry. AAT-D remains undiagnosed in many patients, and there are often long delays between the onset of respiratory symptoms and diagnosis. AAT-D can be readily diagnosed by measurement of the serum or plasma protein level, which should be confirmed by assessing the genotype or protein phenotype when AAT levels are below the normal range. Close monitoring for the development or progression of lung disease or liver disease is required, and can improve the prognosis. We show the case of a 69 year old woman with recurrent respiratory infections and asthma symptoms. These rum levels of AAT were below the normal range, and ZZ genotype was confirmed. The delayed diagnosis of our patient seems to emphasize the need to remind the doctors about AAT-D, frequently associated with asthma or COPD symptoms(AU)

Clinical experience with an elemental diet.

An elemental diet of defined composition and simple chemical form was nutritionally tested in a variety of surgical patients. Complete absorption in the upper gastrointestinal tract and minimal fecal residue proved especially advantageous in patients undergoing abdomianl surgery, and the diet also showed usefulness in patients with feeding problems. The patients responded well clinically, although some of them showed taste fatigue. Minimal variations in blood coagulation and chemistry indicated that the diet was safe, at least as it was used in the patients studied.