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lüll Key current clinical issues in alpha-1 antitrypsin deficiency Stoller JKRespir Care 2003[Dec]; 48 (12): 1216-21; discussion 1221-4Alpha-1 antitrypsin deficiency is a common but under-recognized condition on which respiratory therapists can have a large impact. A key recent development is the issuance of an international evidence-based standards document regarding diagnosis and management of individuals with alpha-1 antitrypsin deficiency. This report summarizes that standards document, which recommends more widespread testing for alpha-1 antitrypsin deficiency, in order to extend the benefits of diagnosis to individuals found to have alpha-1 antitrypsin deficiency. An important aspect of the standards document is that evidence regarding the clinical efficacy of intravenous alpha-1 antitrypsin augmentation therapy is reviewed. Though no definitive support from a randomized clinical trial is available, the weight of evidence favors the clinical efficacy of alpha-1 antitrypsin augmentation therapy, at least in individuals with moderate degrees of established airflow obstruction. On that basis the standards document recommends intravenous augmentation therapy in specified clinical circumstances.|Adolescent[MESH]|Adult[MESH]|Clinical Protocols[MESH]|Humans[MESH]|Infant, Newborn[MESH]|Infusions, Intravenous[MESH]|Mass Screening/*standards[MESH]|Treatment Outcome[MESH]|alpha 1-Antitrypsin Deficiency/*diagnosis/*drug therapy[MESH]|alpha 1-Antitrypsin/*administration & dosage[MESH] |