PMID- 28284783
OWN - NLM
STAT- MEDLINE
DCOM- 20180510
LR  - 20220321
IS  - 2213-2201 (Electronic)
VI  - 5
IP  - 5
DP  - 2017 Sep-Oct
TI  - The Allergist's Role in Detection of Severe Alpha-1 Antitrypsin Deficiency.
PG  - 1302-1306
LID - S2213-2198(17)30016-8 [pii]
LID - 10.1016/j.jaip.2017.01.008 [doi]
AB  - BACKGROUND: Alpha-1 antitrypsin deficiency (AATD) frequently presents as 
      difficult to manage asthma or asthma with fixed obstruction and is well 
      documented as being underdiagnosed in the population. OBJECTIVE: This study aimed 
      to better describe allergists'/immunologists' involvement in the care of patients 
      with AATD and whether they currently contribute to the underdiagnosis by lack of 
      screening for the condition. METHODS: Using the Research Electronic Data Capture 
      tool, we submitted a questionnaire to 500 patients with severe AATD (ZZ, SZ, 
      ZNull, and FZ) through the Alpha-1 Foundation Research Registry to collect 
      information about patient diagnosis and treatment patterns. Approximately 45% 
      completed the questionnaire, leading to a final enrollment of 226 participants. 
      RESULTS: Seventy-eight participants (34%) had seen an allergist, but only 11 (5%) 
      were diagnosed with AATD by their allergist. Likewise, allergists prescribed 
      alpha-1 augmentation therapy to only 5 (8%) of the 59 patients on augmentation 
      therapy. Nearly 46% (n = 104) of all participants were diagnosed with either 
      asthma (28%) or allergic disease (18%) before receiving a diagnosis of AATD. 
      Eighteen patients had been treated with immunotherapy before their diagnosis of 
      AATD, with 94% of these participants receiving treatment for 3 years or longer. 
      CONCLUSIONS: Our data suggest that specialists in Allergy and Immunology should 
      consider and screen for AATD in patients with asthma in whom spirometry does not 
      return to normal. Furthermore, we propose allergists/immunologists are well 
      suited to screen and treat patients with AATD.
CI  - Copyright (c) 2017 American Academy of Allergy, Asthma & Immunology. Published by 
      Elsevier Inc. All rights reserved.
FAU - Kelbel, Theodore
AU  - Kelbel T
AD  - Section of Allergy & Immunology, Division of Pulmonary, Allergy & Critical Care 
      Medicine, Department of Medicine, Penn State Milton S. Hershey Medical Center, 
      Hershey, Pa.
FAU - Morris, Darren
AU  - Morris D
AD  - Penn State Hershey College of Medicine, Hershey, Pa.
FAU - Walker, Deirdre
AU  - Walker D
AD  - Division of Pulmonology, Medical University of South Carolina, Charleston, SC.
FAU - Henao, Maria Paula
AU  - Henao MP
AD  - Section of Allergy & Immunology, Division of Pulmonary, Allergy & Critical Care 
      Medicine, Department of Medicine, Penn State Milton S. Hershey Medical Center, 
      Hershey, Pa.
FAU - Craig, Timothy
AU  - Craig T
AD  - Section of Allergy & Immunology, Division of Pulmonary, Allergy & Critical Care 
      Medicine, Department of Medicine, Penn State Milton S. Hershey Medical Center, 
      Hershey, Pa; Penn State Hershey College of Medicine, Hershey, Pa. Electronic 
      address: tcraig@pennstatehealthcare.edu.
LA  - eng
PT  - Journal Article
DEP - 20170309
PL  - United States
TA  - J Allergy Clin Immunol Pract
JT  - The journal of allergy and clinical immunology. In practice
JID - 101597220
RN  - alpha-1-Antitrypsin Deficiency, Autosomal Recessive
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Allergists
MH  - Asthma/*diagnosis
MH  - Child
MH  - Diagnostic Errors/prevention & control
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Physician's Role
MH  - Pulmonary Disease, Chronic Obstructive/*diagnosis
MH  - Spirometry
MH  - Surveys and Questionnaires
MH  - Young Adult
MH  - alpha 1-Antitrypsin Deficiency/*diagnosis
OTO - NOTNLM
OT  - Allergists
OT  - Alpha-1 antitrypsin deficiency
OT  - Asthma
OT  - COPD
OT  - Diagnosis of AATD
OT  - Emphysema
OT  - Screening for AATD
EDAT- 2017/03/13 06:00
MHDA- 2018/05/11 06:00
CRDT- 2017/03/13 06:00
PHST- 2016/05/23 00:00 [received]
PHST- 2017/01/03 00:00 [revised]
PHST- 2017/01/06 00:00 [accepted]
PHST- 2017/03/13 06:00 [pubmed]
PHST- 2018/05/11 06:00 [medline]
PHST- 2017/03/13 06:00 [entrez]
AID - S2213-2198(17)30016-8 [pii]
AID - 10.1016/j.jaip.2017.01.008 [doi]
PST - ppublish
SO  - J Allergy Clin Immunol Pract. 2017 Sep-Oct;5(5):1302-1306. doi: 
      10.1016/j.jaip.2017.01.008. Epub 2017 Mar 9.