Full Text: Case Report

Alpha₁-Antitrypsin Replacement Therapy Controls Fibromyalgia Symptoms in 2 Patients with PI ZZ Alpha₁-Antitrypsin Deficiency

IGNACIO BLANCO, HORTENSIA CANTO, FREDERICK JOSEPH de SERRES, ENRIQUE FERNANDEZ-BUSTILLO, and MARIA CARMEN RODRÍGUEZ

ABSTRACT.

Two Spanish sisters with a₁-antitrypsin (AAT) deficiency and fibromyalgia (FM) started AAT replacement therapy with commercial a₁-antitrypsin infusions in 1992. They both experienced a rapid, progressive, and constant control of their FM symptoms during the next 6 years (1992-98). However, in 1998, treatment of both patients was affected by the worldwide commercial shortage of AAT replacement therapy; replacement therapy infusions were halted for about 4–6 consecutive months every year for 5 years. As a result, we observed a striking recurrence of FM symptoms. Equally striking was the total disappearance of these symptoms when AAT replacement therapy infusions were resumed. (J Rheumatol 2004;31:2082-5)

Key Indexing Terms:

ALPHA₁-ANTITRYPSIN
FIBROMYALGIA

From the Department of Internal Medicine, Respiratory Diseases Branch, Hospital Valle del Nalón, Asturias, Spain; the Environmental Toxicology Program, Laboratory of Molecular Toxicology, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA; the Biostatistics Unit, Hospital Universitario Central de Asturias; and the Biochemistry Laboratory, Instituto Nacional de Silicosis, Hospital Universitario Central de Asturias, Asturias, Spain.

I. Blanco, MD; H. Canto, MD, Respiratory Diseases Branch,

Hospital Valle del Nalón; F.J. de Serres, PhD, National Institute of Environmental Health Sciences; E. Fernandez-Bustillo, PhD, Biostatistics Unit; M.C. Rodríguez, MD, Instituto Nacional de Silicosis, Hospital Universitario Central de Asturias.

Address reprint requests to Dr. I. Blanco, Department of Internal Medicine, Respiratory Diseases Branch, Hospital Valle del Nalón, 33920 Langreo, Asturias, Spain. E-mail: ignacio.blanco@sespa.princast.es

Submitted June 6, 2003; revision accepted April 16, 2004.