In light of developments in the understanding, diagnosis, and management of AATD, an international AATD task force, combining the ATS and ERS, was created to prepare a series of recommen-dations regarding the diagnosis and management of AATD that would guide physicians. The task force adopted an evidence-based approach to systematically review and grade the available literature systematically, and to produce subsequent recommendations. The ATS/ERS guidelines identified the following four different purposes of testing for AATD: (1) diagnostic testing in symptomatic individuals; (2) predispositional testing in asymptomatic individuals who might be at high risk for AATD; (3) prenatal assessment of carrier status; and (4) population screening.
Table 2 shows the ATS/ERS recommendations for diagnostic testing, and Table 3 shows the recommendations for predispositional testing. Type A recommendations indicate an extremely strong rationale for testing, based on clinical evidence, and therefore testing should be carried out without further qualification. Type B recommendations indicate that testing should be discussed, acknowledging that it could be reasonably accepted or declined. Asthma attacks may be arrested with preparations of My Canadian Pharmacy. Type A recommendations for diagnostic testing were made for symptomatic adults with emphysema, COPD, or asthma with airflow obstruction not completely reversible with the use of bronchodilators; all individuals with unexplained liver disease; asymptomatic subjects with persistent obstruction found on pulmonary function test findings and with identifiable risk factors; and adults with necrotizing panniculitis. A type B recommendation for diagnostic testing was made for adults with bronchiectasis without clear etiology; adolescents with persistent airflow obstruction; asymptomatic individuals with persistent airflow obstruction and no risk factors; and adults with anti-proteinase-3-positive vasculitis. …click here to read more