Testing Criteria

 Tests Required

There are 2 tests required to diagnose alpha-1 antitrypsin deficiency. The first test is an alpha-1 antitrypsin (AAT) level, the second more informative test is an AAT phenotype. An AAT phenotype is the definitive test for AAT deficiency as it precisely identifies the type of AAT protein present in the blood, for example Z or S. Ordering an AAT level will measure how much of this protein is in the blood and is a useful screening tool, for example in the setting of COPD. However, this test does not provide a definitive diagnosis. This is because AAT is an acute phase protein (like CRP) and can be elevated during infection and inflammation. If you have a strong suspicion of AAT deficiency in your patient, or if there is a family history of AAT deficiency, order both AAT level and AAT phenotype.


Who Should be Tested?

The World Health Organisation (WHO), American Thoracic Society (ATS), and European Respiratory Society (ERS) together recommend the following cohorts for screening;

  • COPD, regardless of age or smoking history
  • Severe, non-responsive/refractory asthma
  • Cryptogenic liver disease
  • All first-degree relatives of known Alphas
  • Individuals with reduced serum levels of AAT
  • Panniculitis


Sample Requirements

We require 1 serum or plasma sample – the minimum volume required is 3.0 mls. The blood sample should be carefully labelled with name, DOB, etc. and sent to:

Alpha-1 Foundation Ireland, RCSI Smurfit Building, Beaumont Hospital, Dublin 9.


What Happens Next

The blood sample can be sent directly to the Alpha-1 Foundation where the test is performed. Results of the test are then returned to the requesting doctor in approximately 2 weeks.

 Should you have any further questions please contact us on 01-8093871 or email This email address is being protected from spambots. You need JavaScript enabled to view it..