A prospective evaluation of correlation between cholinesterase level and severity of organophosphorus poisoning

M. Deepak Phanindra; P. V. V. Satyanarayana; Anand Acharya

doi:10.18203/2349-3933.ijam20200079

Authors

M. Deepak Phanindra Department of General Medicine, Konaseema Institute of Medical Science, Amalapuram, Andhra Pradesh, India
P. V. V. Satyanarayana Department of General Medicine, Konaseema Institute of Medical Science, Amalapuram, Andhra Pradesh, India
Anand Acharya Department of Pharmacology, Konaseema Institute of Medical Science, Amalapuram, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20200079

Keywords:

Correlation, Organophosphorus, Serum cholinesterase, Severity

Abstract

Background: Organophosphorus compounds are anticholinesterases by inhibiting cholinesterase it protects acetyl chorine from hydrolysis. So, acetylcholine accumulates at the synapses, and all the clinical manifestation are due to that. So, this study has been designed to establish the reactive between level of serum and prognosis of op poisoning patients.

Methods: Patient with history of organophosphorus poisoning admitted into the emergency department with following exclusion and inclusion criteria were included in this study. All patients were managed as per standard treatment protocol of op poisoning. Various parameters like demography of the patients, sign and symptoms, severity of intoxication, clinical and lab parameter manoring, Serum cholinesterase was measured every alternate day.

Results: 22(47.84%) patients have mild symptom out of that 20 patient’s serum cholinesterase was more than 2000 IU/L, and 2(4.3%) patients serum cholinesterase was between 1000-2000 IU/L. In eighteen patient’s severity as per POP scale was moderate, out of that 2(4.3%) patients have serum cholinesterase was below 1000 IU/L, 8 having serum cholinesterase between 1000 to 2000 IU/L, and remaining eight having serum cholinesterase above 2000 IU/L.

Conclusions: Serum cholinesterase was less in patient with high severity score or low serum concentration of cholinesterase was associated with high severity score. Serum cholinesterase was improved as days passes.

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References

Jeyaratnam J. Acute pesticide poisoning: a major global health problem. World Health Stat Q. 1990;43(3):139-44.

Gunnell D, Eddleston M, Phillips MR, Konradsen F. The global distribution of fatal pesticide self-poisoning: Systematic review. BMC Public Health. 2007;7:357.

Thundiyil JG, Stober J, Besbelli N, Pronczuk J. Acute pesticide poisoning: a proposed classification tool. Bull World Health Org. 2008;86:205-9.

Srivastava A, Peshin SS, Kaleekal T, Gupta SK. An epidemiological study of poisoning cases reported to the national poisons information centre, All India Institute of Medical Sciences, New Delhi. Human Experiment Toxicol. 2005;24(6):279-85.

Hiremath P, Rangappa P, Jacob I, Rao K. Pseudocholinesterase as a predictor of mortality and morbidity in organophosphorus poisoning. Indian J Crit Care Med: Peer-Reviewed, Official Publication Ind Soc Crit Care Med. 2016;20(10):601.

Aygun D, Dognnay Z, Altintop L, Guven H, Onar M, Deniz T, et al. Serum acetylcholinesterase and prognosis of acute organophosphate poisoning. J Toxicol Clin Toxicol. 2002;40:903-10.

Areekul S, Srichairat S, Kirdudom P. Serum and red cell cholinesterase activity in people exposed to organophosphate insecticides. Southeast Asian J Trop Med Public Health. 1981;12:94-8.

Nouira S, Abroug F, Elatrous S, Boujdaria R, Bouchoucha S. Prognostic value of serum cholinesterase in organophosphate poisoning. Chest. 1994;106(6):1811-4.

Senanayake N, de Silva HJ, Karalliedde L. A scale to assess severity in organophosphorus intoxication: POP scale. Hum Exp Toxicol. 1993;12(4):297-9.

Rehiman S, Lohani SP, Bhattarai MC. Correlation of serum cholinesterase level, clinical score at presentation and severity of organophosphorous poisoning. J Nepal Med Assoc. 2008;47(170):47-52.

Banerjee I, Tripathi SK, Roy AS. Clinico-epidemiological characteristics of patients presenting with organophosphorus poisoning. North Am J Med Sci. 2012;4(3):147.

Ahmed SM, Das B, Nadeem A, Samal RK. Survival pattern in patients with acute organophosphate poisoning on mechanical ventilation: A retrospective intensive care unit-based study in a tertiary care teaching hospital. Ind J Anaesth. 2014;58(1):11.

Shivakumar S, Rajan SK, Madhu CR, Doss P, Pasupathy S, Dhandapani E. Profile of acute poisoning in Chennai: A two year experience in Stanley Medical College and Hospital (1999-2000). J Assoc Physicians India. 2002;50:206.

Sungur M, Güven M. Intensive care management of organophosphate insecticide poisoning. Crit Care. 2001;5(4):211.

Chaudhary SC, Singh K, Sawlani KK, Jain N, Vaish AK, Atam V, et al. Prognostic significance of estimation of pseudocholinesterase activity and role of pralidoxime therapy in organophosphorous poisoning. Toxicol intern. 2013;20(3):214.

Nouira S, Abroug F, Elatrous S, Boujdaria R, Bouchoucha S. Prognostic value of serum cholinesterase in organophosphate poisoning. Chest. 1994;106(6):1811-4.

Manu MS, Prashant V, Akila P, Suma MN, Basavanagowdappa H. A retrospective analysis of serial measurement of serum cholinesterase in acute poisoning with organophosphate compounds. Toxicol Intern. 2012;19(3):255.