ALPHA1-ANTITRYPSIN IN TROPICAL PULMONARY EOSINOPHILIA

Serum alpha-antitrypsin (A1AT) was measured in 36 patients (group A) w ith tropical pulmonary eosinophilia (TPE) and 30 patients with pulmona ry eosinophilia with associated worm infestation (group B). Serum A1AT level was also measured in 42 healthy subjects (group C). In 28 patie nts (group A, 15 and group B, 13), the serum A1AT level was below 60 p ercent of the mean A1AT value of the control group. The A1AT-deficient patients had a more severe form of illness with recurrence and relaps e, and they were generally refractory to treatment. In these deficient patients, a significant negative correlation (p<0.02) between A1AT an d absolute blood eosinophil counts (AEC) was observed. In 21 patients (group A, B and group B, 13), the effect of therapy with either diethy lcarbamazine or deworming or both was observed. This showed a signific ant posttreatment rise of A1AT level with a significant fall in AEC (p <0.02) as compared to their respective pretreatment levels. Serum A1AT levels in either or both parents of 11 patients (group A, 5 and group B, 6) were found to be within normal levels. The significant rise in A1AT levels with a significant fall in AEC levels in the patients foll owing therapy and the absence of A1AT deficiency in the parents examin ed indicate that the A1AT deficiency observed in TPE is probably acqui red.