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Alpha-1-antitrypsin deficient man presenting with lung function decline associated with dust exposure: a case report
Moshe Zutler1, Patricia J Quinlan, Paul D Blanc
1505 Parnassus Avenue, M1097, San Francisco, CA 94143, USA. moshe.zutler@ucsf.edu.
Journal of Medical Case Reports
|April 21, 2011
Summary
Individuals with alpha-1 antitrypsin deficiency (AATD) and occupational dust exposure experienced accelerated lung function decline. Monitoring and assessing workplace exposures are crucial for managing AATD-related chronic obstructive pulmonary disease (COPD).
Area of Science:
- Pulmonary Medicine
- Occupational Health
- Genetics
Background:
- Alpha-1 antitrypsin deficiency (AATD) increases susceptibility to chronic obstructive pulmonary disease (COPD).
- Occupational dust exposure is a suspected risk factor for COPD in AATD patients, but individual causality is hard to prove.
Purpose of the Study:
- To present a case study illustrating the link between occupational dust exposure and accelerated lung function decline in an individual with AATD.
- To support the biological plausibility of occupationally associated COPD.
Main Methods:
- Case report of a 68-year-old male with AATD, smoking history, and new-onset dyspnea.
- Evaluation included spirometry over 10 years within a respirator fit program.
- Analysis of forced expiratory volume in one second (FEV1) trends in relation to workplace dust exposure.
Main Results:
- The patient had AATD and developed pulmonary emphysema.
- Spirometry showed a significant decline in FEV1 during periods of high dust exposure.
- FEV1 decline attenuated after cessation of workplace dust exposure.
Conclusions:
- Patients with AATD should be evaluated for occupational exposures.
- Close monitoring for work-accelerated lung function decline is recommended for AATD patients.
- This case supports the multifactorial nature of work-associated COPD.
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