Alpha -1 antitrypsin deficiency presents as ?

Alpha-1 antitrypsin deficiency-associated lung disease is characterized by progressive degenerative and destructive changes in the lungs (emphysema, commonly of the panacinar type). Emphysema is a chronic, usually slowly progressive illness, which most commonly causes shoness of breath. Other symptoms may include chronic cough, phlegm production, and wheezing. Emphysema is caused due to alpha 1 antitrypsin deficiency. Reference: GHAI Essential pediatrics, 8th edition