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What is AATD?

Alpha-1 antitrypsin deficiency (AATD) is the lack of a protein made by the liver that’s released into the bloodstream.

AATD is a genetic disease that can affect the liver or lung. The alpha-1 protein is designed to protect tissues in the body from being attacked by its own enzymes. Children with AATD either don’t produce enough of the alpha-1 protein or the protein produced is abnormal and, therefore, is not released into the bloodstream as it should be. The liver injury in AATD is caused by accumulation of the abnormal protein produced within liver cells.

Symptoms & Causes

What are the symptoms of AATD?

Symptoms of AATD liver disease in children may include:

  • Jaundice at birth that does not go away
  • Dark urine and pale stools
  • Elevated liver enzyme levels
  • Severe itching
  • Enlarged spleen
  • Easy bleeding or bruising

Diagnosis & Treatments

How is AATD diagnosed?

AATD is diagnosed through a simple blood test that measures the level of alpha-1 antitrypsin in the blood.

Your child’s doctor may do other tests to check for liver disease as well. These can include:

  • Ultrasound — to get a better view of your child’s liver
  • Liver biopsy — to examine a sample of liver tissue under a microscope

How is AATD treated?

There is no specific treatment for the liver disease associated with AATD. Not all children affected will develop liver disease — we don't know why this is.

In children with liver disease, treatment is aimed at alleviating symptoms:

  • Medicine to relieve itching
  • Medicine to relieve build-up of body fluid
  • Vitamin supplements to ensure appropriate nutrition and help increase energy levels

In situations where liver disease becomes severe, your child's doctor may recommend a liver transplant.

How we care for AATD

Boston Children's Hospital's Center for Childhood Liver Disease provides comprehensive care for infants, children, adolescents and young adults with a wide variety of liver disorders. If your child has been diagnosed with AATD, we can help. Children with liver disease are referred to this program from all of the United States and from around the world. This program is multidisciplinary and includes hepatology, surgery, interventional radiology, interventional GI, endoscopy, and pathology.

Practitioners Who Specialize In This Condition

Katherine Sweeny, MD

Katherine Sweeny, MD

Associate Director, Fatty Liver Interdisciplinary Program; Gastroenterologist, Division of Gastroenterology, Hepatology and Nutrition
Instructor of Pediatrics, Harvard Medical School
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