Did you know that DAAT patients who have not smoked suffer milder symptoms than smokers?
Are you an AATD patient? we strongly recommend that you go thinking about quitting smoking, we are talking about a basic measure that includes the pioneering guide on patients with DAAT.
The effects can take their toll, since COPD usually develops, a disease that occurs in posterior lids.
AATD in young people
For example, an adolescent who has been detected severe AATD (genotype ZZ), for the moment the young person will be asymptomatic, and over the years they may or may not develop COPD, but what is clear is that if they smoke they will will manifest COPD in earlier stages (30-40 years) and have a worse evolution.
But if you quit smoking, COPD may not show up. That is, the first point of treatment is NO SMOKING ”.
First recommendation: QUIT SMOKING
Second recommendation
Next, it is necessary to inform the patient about the genetic disease that he suffers and about COPD, as well as to discuss the aspects of the evolution that awaits him if he continues to smoke.
Third, the treatment guidelines established by the COPD clinical guidelines for all patients with this condition must be followed.
Third recommendation
Third, the treatment guidelines established by the COPD clinical guidelines for all patients with this condition must be followed.
Tratamientos
Afterwards, there is a specific treatment of AATAD in its severe forms and with manifest clinical signs. Thus, and according to criteria and protocols established in the regulations of the scientific pulmonology societies such as SEPAR, the monthly administration of alpha 1 antitrypsin is administered intravenously, which manages to slow down the evolution of COPD due to AATD.
Treatment
Alpha-1 antitrypsin deficiency is the most common inherited pathology in adults and predisposes, in its severe form, to the development of COPD and various types of liver disease. It is a rare disease with a high underdiagnosis.
If you are DAAT, stop smoking, it is the only way to avoid major problems, since COPD usually develops, a disease that occurs in posterior lids.
Source: IDEMM-FARMA
This document has been presented within the framework of the 41st National Congress of SEMERGEN, held in Gijón 2019. “The early diagnosis of this disorder (DAAT) is essential, and hence the key role of the Primary Care physician”, who, being The first point of contact with the patient (and his family) clears the way to increase “the probability of identifying individuals with AATD and COPD”, Dr. Quintano argues through a statement. The guide has been conceived with three clear objectives.
OBJECTIVES
1) Improve knowledge of COPD by AATD by Primary Care (PC)
2) Sensitize the family doctor about the importance of early diagnosis
3) Provide this professional with resources for the diagnostic approach and to optimize treatment
According to the new document, the clinical manifestations that can lead to suspicion of a case of AATD refer to the symptoms typical of a patient with COPD: dyspnea, cough, expectoration and frequent exacerbations. “In the first place, we must think about the presence of AATAD in patients suffering from COPD, taking into account that it appears in up to 3% of cases. For this reason, the recommendations of all COPD guidelines include in their guidelines that all COPD patients should be requested at least once in their life to measure alpha one antitrypsin (AAT) values. In case they are low values -lower than 60mg / dl-, we can suppose that we are facing a serious AATD, which will have to be demonstrated with the genetic study ”, the doctor specifies.
pHD. Juan Luis García Rivero
Dr. Juan Luis García Rivero, pulmonologist at the Hospital de Laredo (Cantabria), agrees with Dr. Quintano when advising the performance of “a determination of the serum concentration of alpha-1 antitrypsin, at least once in the life, in all patients with COPD ”, and recalls that there is already extensive experience in screening AATD with different devices.
Any patient with COPD can suffer from AATD, but COPD may not be serious and will not affect the evolution of the disease. One must always think that the risk factor that most intervenes in this whole process is the habit of smoking; in fact, if a person with AATD does not smoke, COPD may not become serious. “When we should suspect that we are facing COPD with AATD is in the presentation of COPD in a young patient, generally smoker, between 30-40 years of age, with dyspnea associated or not with coughing, wheezing, expectoration and exacerbations … this would be the typical patient ”, argues Quintano (COPD may not present all these symptoms, but the one that is never lacking is dyspnea).
Phd. Francisco Casas Maldonado
Regarding the need to achieve an early diagnosis of the DAAT, Dr. Francisco Casas Maldonado, pulmonologist at the San Cecilio University Hospital (Granada) and coordinator of the Andalusian Center Alfa1, recalls two initial actions that are basic to reach this diagnosis: the determination of serum alpha-1 antitrypsin concentration in the population at risk, and subsequent confirmation of the disease by phenotyping / genotyping.
