Cirrhosis in a child should raise consideration of AAT deficiency or Wilson disease. Limitations AAT may be elevated into normal range in heterozygous deficient patients during concurrent infection, pregnancy, estrogen therapy, steroid therapy, cancer, and during postoperative periods. Homozygous deficient patients will not show such elevation. Normal AAT levels may occur in patients with liver disease who are heterozygotes. In normals, pregnancy and contraceptive medication may elevate levels.
Levels are normally low at birth but rise soon thereafter.
If CRP is positive, retest AAT in 10-14 days. Additional Information Should be run when alpha 1 globulin in serum protein electrophoresis is low or when two bands are seen in the alpha 1 region. Phenotyping is desirable on patients with low values and on all patients being worked up for AAT-deficient liver disease. An M null genotype will have phenotype as MM but low serum level. These rise rapidly, but nonspecifically, in response to inflammatory insults.