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What if I re-test my phenotype after starting augmentation therapy?

It is interesting to note that individuals on augmentation therapy who have their phenotype re-tested will return a result of PiMZ if they were PiZZ prior to therapy. This is because phenotyping looks at the types of AAT protein in the blood and augmentation therapy delivers normal, PiMM protein to individuals who are PiZZ. Thus, phenotype testing will reveal both the Alpha’s own AAT phenotype, as well as the augmentation-delivered normal phenotype. Genotyping, rather than Phenotyping, would be required to determine an individual’s underlying AAT genetics while on augmentation therapy.

An interesting note Big Fat Reference Guide