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Clinical course and prognosis of never-smokers with severe alpha-1-antitrypsin deficiency (PiZZ).

Tanash, Hanan LU ; Nilsson, Peter M LU ; Nilsson, Jan-Åke LU and Piitulainen, Eeva LU (2008) In Thorax 63. p.1091-1095
Abstract
BACKGROUND: Previous studies of non-smoking individuals with severe alpha-1-antitrypsin deficiency (PiZZ) have been sparse and included only a limited number of individuals, mostly identified by respiratory symptoms. The aim of this study was to estimate the prognosis of non-smoking PiZZ individuals and to analyze the most common causes of death by including a large number of individuals who had been identified due to reasons other than respiratory symptoms. METHODS: The study included 568 non-smoking PiZZ subjects who were selected from the Swedish National AAT Deficiency Registry and followed-up from 1991 to September 2007. Of these, 156 (27%) were identified by respiratory symptoms (respiratory cases) and 412 were identified by extra... (More)
BACKGROUND: Previous studies of non-smoking individuals with severe alpha-1-antitrypsin deficiency (PiZZ) have been sparse and included only a limited number of individuals, mostly identified by respiratory symptoms. The aim of this study was to estimate the prognosis of non-smoking PiZZ individuals and to analyze the most common causes of death by including a large number of individuals who had been identified due to reasons other than respiratory symptoms. METHODS: The study included 568 non-smoking PiZZ subjects who were selected from the Swedish National AAT Deficiency Registry and followed-up from 1991 to September 2007. Of these, 156 (27%) were identified by respiratory symptoms (respiratory cases) and 412 were identified by extra pulmonary symptoms or screening (non-respiratory cases). RESULTS: Ninety-three subjects (16%) died during the follow-up time. The specific Standardized Mortality Rate (SMR) for the whole study population was 2.32 (95% confidence interval (CI) 1.87-2.83) with no significant difference between men and women. The SMR was 2.55 (95% CI 1.91-2.83) for the respiratory cases and 2.07 (95% CI 1.49-2.81) for the non-respiratory cases. Further calculation of SMR for subgroups in the non-respiratory cases showed that the SMR was 0.70 (95% CI 0.14-2.04) for individuals identified by family/population screening. Emphysema and liver cirrhosis were the most common causes of death (45% and 28%, respectively). Malignant transformation was found in 38% of the cirrhotic cases. CONCLUSION: Non-smoking PiZZ individuals identified by screening do not have an increased mortality risk compared with the Swedish general population. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Thorax
volume
63
pages
1091 - 1095
publisher
BMJ Publishing Group
external identifiers
  • wos:000261033800014
  • pmid:18682522
  • scopus:57149107426
  • pmid:18682522
ISSN
1468-3296
DOI
10.1136/thx.2008.095497
language
English
LU publication?
yes
id
bb4f261b-b2ec-4bf8-a867-7617836add1b (old id 1223450)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18682522?dopt=Abstract
date added to LUP
2016-04-04 09:34:14
date last changed
2024-02-14 13:36:07
@article{bb4f261b-b2ec-4bf8-a867-7617836add1b,
  abstract     = {{BACKGROUND: Previous studies of non-smoking individuals with severe alpha-1-antitrypsin deficiency (PiZZ) have been sparse and included only a limited number of individuals, mostly identified by respiratory symptoms. The aim of this study was to estimate the prognosis of non-smoking PiZZ individuals and to analyze the most common causes of death by including a large number of individuals who had been identified due to reasons other than respiratory symptoms. METHODS: The study included 568 non-smoking PiZZ subjects who were selected from the Swedish National AAT Deficiency Registry and followed-up from 1991 to September 2007. Of these, 156 (27%) were identified by respiratory symptoms (respiratory cases) and 412 were identified by extra pulmonary symptoms or screening (non-respiratory cases). RESULTS: Ninety-three subjects (16%) died during the follow-up time. The specific Standardized Mortality Rate (SMR) for the whole study population was 2.32 (95% confidence interval (CI) 1.87-2.83) with no significant difference between men and women. The SMR was 2.55 (95% CI 1.91-2.83) for the respiratory cases and 2.07 (95% CI 1.49-2.81) for the non-respiratory cases. Further calculation of SMR for subgroups in the non-respiratory cases showed that the SMR was 0.70 (95% CI 0.14-2.04) for individuals identified by family/population screening. Emphysema and liver cirrhosis were the most common causes of death (45% and 28%, respectively). Malignant transformation was found in 38% of the cirrhotic cases. CONCLUSION: Non-smoking PiZZ individuals identified by screening do not have an increased mortality risk compared with the Swedish general population.}},
  author       = {{Tanash, Hanan and Nilsson, Peter M and Nilsson, Jan-Åke and Piitulainen, Eeva}},
  issn         = {{1468-3296}},
  language     = {{eng}},
  pages        = {{1091--1095}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Thorax}},
  title        = {{Clinical course and prognosis of never-smokers with severe alpha-1-antitrypsin deficiency (PiZZ).}},
  url          = {{http://dx.doi.org/10.1136/thx.2008.095497}},
  doi          = {{10.1136/thx.2008.095497}},
  volume       = {{63}},
  year         = {{2008}},
}