Familial occurrence of alpha 1-antitrypsin deficiency and Weber-Christian disease.

Severe panniculitis of the Weber-Christian type occurred in two brothers, both with marked alpha 1-antitrypsin (alpha 1-AT) deficiency and phenotype PiZZ. Studies of inflammatory and immunologic function were undertaken in these two patients as well as in a third brother with severe alpha 1-AT deficiency but without Weber-Christian disease. The findings of these investigations were suggestive of exaggerated immunologic and inflammatory function with enhanced lymphocyte responsiveness to phytohemagglutinin, enhanced activation of neutrophils and monocytes, and accelerated delayed hypersensitivity responses in all three subjects. This hyperreactivity may explain the apparent association of alpha 1-AT deficiency with Weber-Christian disease.