Alpha-1 antitrypsin (AAT) Test

AAT deficiency causes liver and lung disorders in young adults and children. Doctors advise this test for patients who have a strong family history of liver or lung disorders and are likely to have AAT deficiency. An AAT test is also recommended for patients who exhibit the following signs and symptoms:

• Emphysema – a progressive lung disease which causes difficulty in breathing
• Prolonged wheezing
• Uncontrollable asthma even after aggressive treatment
• Repeated respiratory tract infections
• Shortness of breath during mild exercise
• Increase in heartbeat on standing
• Presence of blood in vomit
• Liver problems in young children
• Unintentional weight loss
• Infants who have yellow skin and eyes
• Swollen abdomen, legs and feet
  
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No special preparations are needed for this test. Your doctor will explain to you the purpose of the test and how it will be done. Generally, patients are not required to fast (avoid eating and drinking) before the test; however, people with hyperlipidaemia (increased levels of fat in the blood), the will be recommended eight to 10 hours of fasting before the test is done.

(Health checkup app)

• A skilled technician will withdraw 7 mL of blood from a vein in your arm after cleaning the site of puncture using povidone-iodine and tightening an elastic band above the site 
• You may experience pain or soreness at the site of needle insertion for a while after the test. Though it does not last long
• After the blood is withdrawn, the technician will remove the elastic band, put a mild pressure to the site of puncture and apply a dressing strip. This helps stop bleeding and prevent infection 
• The blood sample will be labelled and sent to a laboratory for analysis

Normal results:

100-200 mg/dL (18.4-36.8 μmol/L) of AAT in the blood is considered as normal. However, the reference values for normal range would vary at different laboratories depending on the method of testing employed.

Abnormal results:

AAT test results are considered abnormal when the serum levels of Alpha-1 Antitrypsin are less than 70 mg/dL (<12.9 μmol/L). Such low levels of AAT indicate that these patients may be at risk of developing early lung disease and require genetic testing. Although patients with AAT levels less than 125 mg/dL (<23 μmol/L) are not at high risk of lung disorders such as emphysema, doctors may recommend them to undergo further evaluation including genetic tests based on their symptoms.

Abnormal results of the AAT test may be seen in the following clinical conditions:

• Chronic liver disease
• Chronic lung disease
• Hepatic damage 
• Emphysema
• Nephrotic syndrome, a condition in which kidneys excrete a large amount of proteins
• Jaundice 
• Liver cirrhosis

In many inflammatory conditions, AAT secretion is increased and results in its elevated levels. Drugs such as oestrogen, steroids and oral contraceptives may also increase the levels of AAT. The following conditions may also result in elevated levels of AAT:

• Systemic lupus erythematosus
• Cancer
• Pregnancy, especially in later stages of gestation
• Stress

If the results of the test suggest the presence of serious conditions, doctors may recommend further testing. You may also be advised to avoid smoking and exposure to dust and chemicals as they can aggravate lung disease.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.