Moderate obstruction on PFT with some scarring on CT scan
I am a 52 year old woman who never smoked. I am an MZ for antitrypsin deficiency and my levels were 22. I have had a dry cough and shortness of breath for 4-5 months. I recently had a PFT that showed the following:
The FVC, FEV1, FEV1/FVC ratio and FEF25-75% are reduced indicating airway obstruction. The FVC is reduced relative to the SVC indicating air trapping. The airway resistance is normal. While the TLC and RV are within normal limits, the FRC is reduced. Following administration of bronchodilators, there is no significant response. The reduced diffusing capacity indicates a mild loss of functional alveolar capillary surface. However the diffusing capacity was not corrected for patient’s hemoglobin.
Conclusions: Moderate partially reversible obstructive respiratory defect with moderate loss of whole lung units.
CT scan came back negative for emphysema but showed some scarring. Can you help me understand the test results and what next steps should be?
Normal values of alpha one vary from lab to lab so I am not sure where your value of 22. See the following table.
TABLE 1 – AAT Serum Levels
Units of Measurement Example Normal Range* Example Abnormal Result Example Normal Result
mg/dl 75-150 35 105
µM > 22 6 28
G/L 0.075-0.15 0.04 0.1
*actual normal ranges vary from laboratory to laboratory
Your pulmonary function test levels are consistent with a number of lung diseases expressed as obstruction to air flow.
What troubles me is the recent onset (4-5 months) of dry cough and shortness of breath; that remains unexplained by your PFT’s and CT scan and is reason for concern. I recommend that you seek consultation with a lung specialist (pulmonologist) for further diagnostic studies.
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