First, the general practitioner or pulmonologist determines the serum level of alpha-1 antitrypsin in the patient's blood using a few drops of blood. This can be done as part of a routine laboratory test. If the serum level is below a certain threshold, this indicates an alpha-1 antitrypsin deficiency. In this case, the patient's blood undergoes further analysis, and laboratory diagnostic tests (phenotyping and genotyping) provide information about the type of genetic alteration (mutation).
It is important to note that serum levels can more than double during inflammation, infection, or injury, and people with PiMZ or PiMS can have serum levels similar to those of healthy individuals (PiMM). Therefore, in cases of AAT deficiency, one should not rely solely on protein levels, as is often the case with certain other conditions. international study from 2021. The authors always suggest additional genetic analysis in all suspected cases.

