We present our experience with 18 pediatric patients with a,-antitrypsin deficiency of the PiZZ phenotype. Fifteen patients (83%) presented with neonatal cholestatic jaundice at a mean age of 2 f 0.6 months (2S.D.). The ma1e:female ratio was 15:3, indicating a male predominance. All metabolic, infec
The liver in adolescents with α-antitrypsin deficiency
✍ Scribed by Tomas Sveger; Sten Eriksson
- Publisher
- John Wiley and Sons
- Year
- 1995
- Tongue
- English
- Weight
- 456 KB
- Volume
- 22
- Category
- Article
- ISSN
- 0270-9139
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✦ Synopsis
Pis-) children have been followed prospectively, of whom 1 PiSZ and 5 PiZ children died in early childhood. We now report clinical and biochemical signs of liver disease in adolescence and the prognosis of neonatal liver disease up to the age of 18 years. The tu,ATD subjects were offered a clinical checkup and liver tests at 16 and 18 years of age, 150 of 178 cvlATD subjects undergoing checkups at age 16 and 166 at age 18. Liver tests were performed in 121 adolescents at both the 16-and 18-year checkups. None of the PiZ and PiSZ subjects checked at the age of 16 and 18 years had any clinical signs of liver disease. Abnormalities of serum alanine aminotransferase (S-ALAT) or y-glutamyl transferase (S-GT) were found at the 16-year checkup (all PiZ and PiSZ subjects tested included) in 17ri of PiZ and 852 of PiSZ adolescents, and at the age of 18 years in 12rr of PiZ and 15ci of PiSZ subjects. In only two cases were both S-ALAT and S-GT concentrations abnormal at both the 16-year and IS-year follow-ups. Serum procollagen III peptide concentrations were normal in all those with abnormal liver test results. Of 127 PiZ subjects, 22 had manifested clinical signs of liver disease in infancy. Of these 22, two died early in life of cirrhosis. Another two children died of other causes; however, autopsy showed histological signs of cirrhosis in one of them, fibrosis in the other. All of the remaining 18 subjects were clinically healthy at the 16-and 18-year checkups. Marginal liver test abnormalities were found in two of them. To sum up, alATD children followed prospectively up to 18 years of age continue to have favorable prognosis.
📜 SIMILAR VOLUMES
alpha-1-antitrypsin; PiZZ, a1-ATZ phenotype; ER, endoplasmic acts with the target P 1 -P 1 residues of the reactive center loop, reticulum; MHC, major histocompatibility complex. the loop inserts further into the gap in the A sheet, generating From the: Departments of Pediatrics, Cell Biology, and
Controversy exists whether patients who are genetically heterozygous for 1-antitrypsin deficiency (1ATD), carrying a single PI\*Z allele, are at increased risk of developing chronic liver disease. In these investigations, we determined the prevalence of heterozygous 1AT phenotypes (PI MZ, PI SZ) in
The human serum protein u,-antitrypsin is the major source of antiprotease activity found in the blood. The protein is synthesised primarily by liver cells but, to a lesser extent, by at least one other cell type. Expression of the gene has provided a paradigm for studies on transcriptional regulati