Case study: Alpha₁-antitrypsin deficiency in a burn patient

A child with a history of alpha antitrypsin deficiency sustained a 13% total body surface area burn. He underwent two skin grafting procedures, the wounds healing without hypertrophic scarring. The pulmonary and heptic complications of this disease have been well documented. Other systemic manifestations include pancreatic fibrosis, panniculitis, and arthritis. It is our hypothesis that the lack of postburn hypertrophie scarring in this patient was due to the protease-inhibi-tor imbalance that predominates in the tissue-destructive processes affecting the other organ systems.