RT Journal Article SR Electronic T1 What is Pi (proteinase inhibitor) null or PiQO?: a problem highlighted by the alpha 1 antitrypsin Mheerlen mutation. JF Journal of Medical Genetics JO J Med Genet FD BMJ Publishing Group Ltd SP 27 OP 29 DO 10.1136/jmg.29.1.27 VO 29 IS 1 A1 N Kalsheker A1 K Hayes A1 S Weidinger A1 A Graham YR 1992 UL http://jmg.bmj.com/content/29/1/27.abstract AB alpha 1 antitrypsin deficiency is associated with predisposition to the development of pulmonary emphysema and childhood cirrhosis. There are two common deficiency alleles in the European population, proteinase inhibitor (Pi) Z and S. In addition, there are rare Pinull or QO variants which can be difficult to diagnose. A family assigned as having the PiQO allele by AAT protein quantification and isoelectric focusing was shown by DNA sequencing to have the PiMheerlen mutation (Pro369-Leu). This highlights the difficulties of diagnosis of PiQO.