[Screening for alpha1-antitrypsin deficiency using dried blood spot: Assessment of the first 20 months]

Rev Mal Respir. 2020 Oct;37(8):633-643. doi: 10.1016/j.rmr.2020.08.001. Epub 2020 Aug 25.
[Article in French]

Abstract

Introduction: Alpha1-antitrypsin deficiency is a predisposing factor for pulmonary disease and under-diagnosis is a significant problem. The results of a targeted screening in patients with respiratory symptoms possibly indicative of severe deficiency are reported here.

Methods: Data were collected from March 2016 to October 2017 on patients who had a capillary blood sample collected during a consultation with a pulmonologist and sent to the laboratory for processing to determine alpha1-antitrypsin concentration, phenotype and possibly genotype.

Results: In 20 months, 3728 test kits were requested by 566 pulmonologists and 718 (19 %) specimens sent: among these, 708 were analyzable and 613 were accompanied by clinical information. Of the 708 samples, 70 % had no phenotype associated with quantitative alpha1- antitrypsin deficiency, 7 % had a phenotype associated with a severe deficiency and 23 % had a phenotype associated with an intermediate deficiency. One hundred and eight patients carried at least one PI*Z allele which is considered to be a risk factor for liver disease.

Conclusions: The results of this targeted screening program for alpha1- antitrypsin deficiency using a dried capillary blood sample reflect improvement in early diagnosis of this deficiency in lung disease with good adherence of the pulmonologists to this awareness campaign.

Keywords: Alpha1-antitrypsin; Alpha1-antitrypsine; Bronchiectasis; Bronchopneumopathie chronique obstructive; Chronic obstructive pulmonary disease; Dilatation des bronches; Dried blood spot testing; Dépistage sur goutte de sang séché; Emphysema; Emphysème.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bronchiectasis / blood
  • Bronchiectasis / diagnosis
  • Bronchiectasis / genetics
  • Child
  • DNA Mutational Analysis / methods
  • DNA Mutational Analysis / standards
  • Dried Blood Spot Testing / methods*
  • Dried Blood Spot Testing / standards
  • Female
  • France / epidemiology
  • Genetic Predisposition to Disease
  • Genotype
  • Humans
  • Longitudinal Studies
  • Male
  • Mass Screening / methods*
  • Mass Screening / organization & administration
  • Middle Aged
  • Phenotype
  • Program Evaluation
  • Pulmonary Disease, Chronic Obstructive / blood
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / genetics
  • Pulmonary Emphysema / blood
  • Pulmonary Emphysema / diagnosis
  • Pulmonary Emphysema / genetics
  • Young Adult
  • alpha 1-Antitrypsin / analysis
  • alpha 1-Antitrypsin / genetics
  • alpha 1-Antitrypsin Deficiency / blood
  • alpha 1-Antitrypsin Deficiency / diagnosis*
  • alpha 1-Antitrypsin Deficiency / epidemiology
  • alpha 1-Antitrypsin Deficiency / genetics

Substances

  • SERPINA1 protein, human
  • alpha 1-Antitrypsin