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A 36-year-old man, a non-smoker, has increasing dyspnea. Spirometry reveals a decreased FEV1/FVC ratio with increased total lung capacity. He experiences an episode of hematemesis, and upper endoscopy demonstrates lower esophageal varices. Which of the following laboratory test findings is most likely to be present:

A Positive serum antinuclear antibody test

B Elevated serum anti-mitochondrial antibody

C Decreased serum alpha-1-antitrypsin

D Increased sweat chloride

E Elevated serum IgE

cirrhosis, emphysema, has to be C.

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