Clinical significance of serum amylase and glucose level in organophosphorus poisoning

Abstract

Background: Organophosphorous(OP) poisoning is a common problem in country like Nepal where agriculture is the backbone of the economy. The primary mechanism of action is inhibition of acetylcholinesterase(ACHE). Organophosphorus poisoning is a possible cause of acute pancreatitis along with alternation of glucose metabolism. Materials and Method: This was a hospital based crosssectional comparative study. The level of serum amylase and glucose were measured in thirty-eight OP poisoned patients at the time of admission, before discharge and were compared. Results: Amongst 38 patients, Majority had mild OP poisoning 27(71.1%) as per Peradeniya Organophosphorus Poisonin(POP) score whereas 9(23.7%) had moderate and 2(5.2%) had severe poisoning. The mean initial serum amylase level in patients with mild poisoning was 152±73.92 (IU/L)(p=0.000), in moderate poisoning was 213.38±69.39 (IU/L) (p=0.223) and in severe poisoning was 171.33±107.22(IU/L) (p=0.259). There was increase in serum amylase level in all patients with poisoning but level did not increase in proportion to increase with severity of POP score. The mean initial serum glucose level in mild poisoning was 132.48±37.73 (Mg/dl) (p=0.024), in moderate poisoning was 139±44.59 (Mg/dl) (p=0.033) and in severe poisoning was 174±23.38 (Mg/dl)(p=0.22). The serum glucose level increased as the severity of POP score increased. The serum amylase and glucose levels in recovering patients showed a tendency to decrease to their normal values. No patient had developed acute symptomatic pancreatitis. Conclusion: Serum amylase and glucose level were increased in all patients with OP poisoning but didn't correlate with the clinical severity. Routine measurement of serum amylase in patients of OP poisoning has little value in the absence of clinical acute pancreatitis.Clinical significance of serum amylase and glucose level in organophosphorus poisoning Koirala M et. al.

Amylase and Lipase Enzymes as Factors Affecting Acute Organophosphorous Poisoning Morbidity and Mortality

“…However, Koirala et al (2019) found that all patients with OPIs poisoning had elevation in serum amylase level but the level did not proportionate with the severity of poisoning assessed by POP score, and this increase in serum amylase usually decreases or regains to normal in survived patient at period of admission.…”