Role of Plasma Cholinesterase level in Assessment of Severity and Outcome in Organophosphorus Poisoning

Abstract For assaying plasma cholinesterase (EC 3.1.1.8) activity and phenotyping by means of dibucaine inhibition, we have compared a commercially available kit, in which butyrylthiocholine is used as substrate, with two reference methods, one using benzoylcholine and the other propionylthiocholine. With 50 different samples of three of the most common genetic variants, we could clearly differentiate the variants with benzoylcholine and dibucaine, whereas there was some overlap of the E1uE1u and E1uE1a phenotypes with the other two substrates at 30 degrees C. The phenotypes were better differentiated at 25 degrees C, and in our hands the use of butyrylthiocholine was preferable to propionylthiocholine for phenotyping with dibucaine. The affinity of the usual and atypical homozygotes for fluoride with butyrylthiocholine gave an inverted response to the affinity of these variants for the anion with benzoylcholine. We suggest that this may be explained by the role of the chromogen or its products in the assay procedure with the thiocholine substrate.

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The effect of plasmapheresis on plasma cholinesterase levels in a patient with organophosphate poisoning

Human & Experimental Toxicology ◽

10.1191/0960327104ht462cr ◽

2004 ◽

Vol 23 (7) ◽

pp. 365-368 ◽

Cited By ~ 15

Author(s):

Muhammet Güven ◽

Murat Sungur ◽

Bülent Eser

Keyword(s):

Normal Values ◽

Fresh Frozen Plasma ◽

Plasma Cholinesterase ◽

Organophosphate Poisoning ◽

Fresh Frozen ◽

Medical Intensive Care ◽

High Level ◽

Plasma Measurements ◽

Frozen Plasma

Objective: To describe the role of plasmapheresis in management of organophosphate poisonings. Design: Case report. Setting: A medical intensive care unit of a medical faculty. Patient: A patient with organophosphate poisoning whose cholinesterase levels continuously decline and then increase up to a normal level after plasmapheresis is performed for his sepsis. Interventions: Plasmapheresis with fresh frozen plasma. Measurements and main results: Baseline plasma cholinesterase (ChE) level was 4001 IU/L (normal values: 4000-10000 IU/L). Aspiration pneumonia was developed on day 3, and sepsis occurred on day 5. During this period, ChE levels gradually decreased. On day 5, plasmapheresis was performed for sepsis. Interestingly, plasma ChE levels increased from 2101 IU/L to 6144 IU/L after plasmapheresis. Atropine and pralidoxime were stopped, and a high level of ChE continued during hospitalization. The patient was successfully weaned from mechanical ventilation 3 days after plasmapheresis. Conclusion: Plasma exchange therapy may be considered for patients with organophosphate poisoning unresponsive to atropine and pralidoxime.

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THE ROLE OF ESTERASE INHIBITION IN TETRAETHYLPYROPHOSPHATE POISONING IN THE HOUSEFLY, MUSCA DOMESTICA L.

Canadian Journal of Biochemistry and Physiology ◽

10.1139/y60-176 ◽

1960 ◽

Vol 38 (1) ◽

pp. 1417-1430 ◽

Cited By ~ 2

Author(s):

D. Stegwee

Keyword(s):

Musca Domestica ◽

Subsequent Treatment ◽

Toxic Action ◽

Acetylcholinesterase Inhibition ◽

Esterase Inhibition ◽

Organophosphorus Poisoning ◽

Biochemical Lesion

The effect of tetraethylpyrophosphate (TEPP) was studied on the in vivo activity of different esterases in the housefly. TEPP was found to cause inhibition of the acetylcholinesterase and of the ali-esterase which hydrolyzes ethylbutyrate. The latter esterase could be selectively inhibited in vivo by treating the flies with tri-o-cresylphosphate (TOCP). Typical symptoms of organophosphorus poisoning developed only after TEPP when acetylcholinesterase was inhibited. Inhibition of this enzyme coincided with a rise of the level of acetylcholine in the insects. Treatment with TOCP caused a lowering of the level of acetylcholine. The insects became less sensitive to subsequent treatment with TEPP and in this case showed a lesser degree of accumulation of acetylcholine. The importance of acetylcholinesterase and ali-esterase in TEPP poisoning is discussed. It is concluded that the major biochemical lesion effected was the inhibition of acetylcholinesterase. Inhibition of the ali-esterase was not directly related to the toxic action of TEPP, although possibly it led to interference with the accumulation of acetylcholine resulting from the acetylcholinesterase inhibition.

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Plasma cholinesterase: double-edged parameter in the diagnosis of acute organophosphorus poisoning

Medicine Science and the Law ◽

10.1258/msl.2010.100015 ◽

2010 ◽

Vol 50 (3) ◽

pp. 159-160 ◽

Cited By ~ 4

Author(s):

D R Mahadeshwara Prasad ◽

Hareesh S Gouda ◽

Vinay R Hallikeri

Keyword(s):

Biochemical Marker ◽

Organophosphorus Pesticides ◽

Clinical Signs ◽

Organophosphorus Pesticide ◽

Signs And Symptoms ◽

Acute Poisoning ◽

Plasma Cholinesterase ◽

Pesticide Poisoning ◽

Organophosphorus Poisoning ◽

Clinical Signs And Symptoms

Biochemical markers are one of the mainstays in the diagnosis of ill health. Plasma cholinesterase is one such marker of the ill health caused by acute organophosphorus pesticide poisoning. Organophosphorus pesticides are powerful inhibitors of plasma cholinesterase; consequently, the reduced level of this biochemical marker has been used in the diagnosis of cases of acute poisoning. But how dependable is this biochemical marker in the diagnosis of suspected organophosphorus pesticide poisoning without adequate clinical signs and symptoms? In the case reported here, the low level of plasma cholinesterase which was suspected to be due to organophosphorus poisoning was found to be caused by pulmonary Koch's and hepatitis B with associated malnutrition.

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Study of role of prognostic markers in the management of organophosphorus poisoning patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20182276 ◽

2018 ◽

Vol 6 (6) ◽

pp. 1996

Author(s):

Sameer Chaudhary ◽

Rohan Kalmegh

Keyword(s):

Scale Score ◽

Prognostic Markers ◽

Initial Presentation ◽

Serum Cholinesterase ◽

Ventilator Support ◽

Organophosphorus Poisoning ◽

Severe Group

Background: POP scale and serum cholinesterase levels may be effective indicators for mortality in organophosphorus poisoning. The objective of this study was to assess the POP scale score and serum cholinesterase levels at initial presentation in OP poisoning and its correlation with need for ventilator support and mortality.Methods: One hundred and fifty eligible participants were recruited, and POP scale and serum cholinesterase levels were assessed.Results: Total 32.7% patients died; of which 30 out of 75 belonged to moderate and 19 out of 22 patients belonged to severe group; as per POP scale score. 49 out of 75 in moderate poisoning and all patients in severe poisoning required ventilator support. With respect to serum cholinesterase level; 20 out of 23 and 29 out of 77 patients died in the severe and moderate poisoning categories respectively. Forty eight out of 77 in moderate poisoning and all patients in severe poisoning required ventilator support.Conclusions: Assessment by POP scale and serum cholinesterase levels is useful in assessing the need for ventilator support and are indicators of mortality in OP poisoning cases.

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