SERPINA1 and hyperinsulinemic hypoglycemia, familial, 4: However, many authors have also put forward other concepts and hypotheses, such as mild-course cystic fibrosis (Majka et al. 2003; Persson et al. 2005), alpha-1-antitrypsin deficiency causing emphysema (Kuzemko 1994), mitral stenosis (O’Shea 1990), and several others, more or less medically substantiated (idiopathic bronchiectases, primary ciliary dyskinesia, hypogammaglobulinemia, allergic bronchopulmonary aspergillosis, tricuspid valve incompetence, Churge-Strauss syndrome, pulmonary hemosiderosis, pulmonary arteriovenous malformation) (Neumayr 1997; Lagerberg 2011).