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Enzyme deficiency can cause emphysema
To your good health
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DEAR DR. DONOHUE: I would like to call your attention to a question you answered about emphysema. I think you should have mentioned alpha-1 antitrypsin deficiency. It would have been a good opportunity to bring this condition to the public’s attention. I have it and was diagnosed at age 53, after having been misdiagnosed for eight years. I have been on Prolastin, which has stabilized my lung capacity. While more doctors are aware of this condition, there are some who are not. -- D.C.

ANSWER: Lungs come equipped with their own janitorial crew. They inhale lots of foreign debris, and they create trash in their work of transferring oxygen into the blood and carbon dioxide out of it. The cleanup crew is trypsin, an enzyme. Trypsin, however, can go overboard, so another enzyme, called alpha-1 antitrypsin, stops it from overdoing the trash collection and destroying air sacs in the process. Emphysema is destruction of those delicate structures. Cigarette smoking is the No. 1 cause of emphysema, also known as one of the chronic obstructive pulmonary diseases, COPD.
Symptoms of emphysema, regardless of cause, include shortness of breath with little physical exertion, cough and increased sputum production.
The delay in your diagnosis of alpha-1 antitrypsin deficiency is par for the course. On average, the diagnosis takes eight years from the time a person first visits a doctor for emphysema symptoms. This illness should come to mind when a relatively young person or a person who has never smoked develops emphysema. A simple blood test for the level of the antitrypsin enzyme can secure the diagnosis.
Treatment is the same as treatment for smoking-caused emphysema. However, there is an additional treatment for alpha 1 antitrypsin deficiency emphysema. Intravenous infusions of the missing enzymes can benefit those with the deficiency. Your Prolastin is one such product.
The booklet on emphysema and chronic bronchitis, the two chronic obstructive pulmonary diseases, discusses the more-common variety in detail. To obtain a copy, write: Dr. Donohue -- No. 601W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.


DEAR DR. DONOHUE: I am inquiring about sebaceous cysts. During the past 20 years, I have had between eight and 10 of them on my back. They were removed surgically. My former family doctor, now retired, said there may be some prescription pills that can stop them from returning. I would like some insight from you. -- W.M.

ANSWER: Sebaceous cysts are also known as epidermal cysts. Often found on the back, they’re firm, round lumps that grow slowly. They can be pushed a little from side to side. Their cause is unknown.
If they’re inflamed or painful, they can be cut out without a lot of trouble, usually in the doctor’s office. The cyst wall must be taken too, or the cyst will return. Simply draining one of the pasty, greasy material contained inside doesn’t end the problem.
Everyone would love to know of a pill that prevents or gets rid of them. I don’t know of one, and I don’t believe there is one.


Donohue does not answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
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