Serum Acetylcholinesterase and Prognosis of Acute Organophosphate Poisoning

Aygün, Dursun; Doğanay, Zahide; Altıntop, Levent; Güven, Hakan; Onar, Musa; Deniz, Turgut; Sünter, Tevfik

doi:10.1081/clt-120016962

Cited by 163 publications

(114 citation statements)

References 22 publications

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“…Goswamy et al have stated that measurement of the acetylcholinesterase level is useful in predicting the prognosis in OP poisoning,13 but the dominant view is that there is no relationship. In a study conducted by Aygun et al on patients with OP poisoning, acetylcholinesterase levels on admission were evaluated, and low levels of serum acetylcholinesterase were reported to support the diagnosis of acute OP poisoning, but acetylcholinesterase levels were not related to clinical severity 14. In the study conducted by Cherian et al on 21 patients with OP poisoning, no significant difference was found in serum acetylcholinesterase levels between the group treated with pralidoxime and the group that received placebo 15.…”

Section: Discussionmentioning

confidence: 99%

The prognostic value of the Glasgow coma scale, serum acetylcholinesterase and leukocyte levels in acute organophosphorus poisoning

Cander

Dur

Yıldız

et al. 2011

Annals of Saudi Medicine

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BACKGROUND AND OBJECTIVES:Organophosphate poisoning (OP) is a serious clinical condition that may sometimes be fatal. The aim of this study was to determine whether the Glasgow coma scale (GCS), and serum acetylcholinesterase and leukocyte levels have prognostic value in acute OP poisoning.DESIGN AND SETTING:Retrospective review of records of patients admitted to the intensive care unit of Selcuk University, Meram Medical Faculty, Emergency Department, Konya, Turkey, between January 2006 and January 2009.METHODS:We studied acutely OP-poisoned patients admitted within 24 hours after OP exposure.RESULTS:The mean age of the 25 patients was 37 years (range, 20-80 years). Three (12%) of the 25 patients (male-female ratio, 12:13) died. The mean GCS values of the patients who died were significantly lower compared to those of the group that survived (4 vs 11.7, respectively P<.05). While the mean serum acetylcholinesterase levels were lower in the patients who died, the difference in the mean serum acetylcholinesterase levels between the patients who died and the ones who survived was not statistically significant (3841 IU/L vs. 1768 IU/L, respectively).CONCLUSION:Although serum cholinesterase values can be used in the quick diagnosis, their efficiency at predicting outcome in patients with OP poisoning has not been established. It has also been determined that serum leukocyte values have no prognostic value in OP poisoning, but GCS values have been found to be effective in predicting the outcome.

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Section: Discussionmentioning

confidence: 99%

The prognostic value of the Glasgow coma scale, serum acetylcholinesterase and leukocyte levels in acute organophosphorus poisoning

Cander

Dur

Yıldız

et al. 2011

Annals of Saudi Medicine

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“…8 As of today only very few studies has shown that serum cholinesterase (ChE) and CPK level estimations are useful in diagnosis of organophosphorus poisoning in acute phase. 9,10 Hence, this study was planned for assessing CPK as a diagnostic and prognostic marker in patients with acute organophosphorus compound poisoning.…”

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confidence: 99%

Creatinephosphokinase in organophosphorus poisoning

Kumar

Virupakshappa

2017

Int J Adv Med

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Background: Organophosphorus Poisoning has been found to be a major cause of death or morbidity in our country as it freely available without need of prescription unlike in developed countries where prescription is required to purchase insecticides, the various organophosphorus compounds available are Malathion, parathion, diazinon, fenthion, dichlorvos, chlorpyrifos, ethion. Erythrocyte cholinesterase (EchE) and pseudocholinesterase (Butyryl cholinesterase-BchE) are markers used for assessing the severity in OP poisoning, but estimation of these are costly, has variable values for different individuals and is not available at all centers. This study was done to estimate levels of serum Creatine Phosphokinase (CPK)serially in acute OP poisoning patients and to correlate with prognosis.Methods: 50 patients of organophosphorus poisoning admitted to Mcgann hospital attached to Shimoga institute of medical sciences Shimoga over a period of 6 months from 1st July 2016 to 31st December 2016 were taken up for the study. A comprehensive history and detailed clinical examination was performed and patients were clinically evaluated for severity. Level of serum cholinesterase and serum CPK were estimated at admission and CPK level was measured on day 3 and day 5. The outcome of these patients was evaluated.Results: Out of 50 patients, 78% (n=39) were males and 22% (n=11) were females. Majority of patients were in the age group 21 – 40 years. Chlorpyrifos was the most common compound used. 72% had mild, 20% had moderate and 8% had severe poisoning. Serial measurements of serum CPK levels showed significant correlation with the severity of acute OP poisoning patients. The CPK levels showed a sensitivity of 74% and a specificity of 81% with a positive predictive value of 92%.Conclusions: Severe organo phosphorus poisoning is correlated with CPK levels. This study recommends CPK level estimation in assessment of severity and prognosticate patients with organophosphorus compound as alternate marker to choline esterase.

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“…[19,20] Aygun ve ark. 'nın [21] hastaneye OF zehirlenmesi ile başvu-ran hastalar ile yaptıkları bir çalışmada, hastaların başvuru-dan itibaren seri KE düzeyleri değerlendirilmiş ve düşük serum KE seviyesinin akut organik fosfor zehirlenmesinin tanı-sını desteklediği, fakat klinik şiddeti ile ilişkili olmadığı bildirilmiştir.…”

Section: Discussionunclassified

The favorable effects of vitamin E added on treatment of experimental acute organophosphate toxicity

et al. 2011

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ÖZET AmaçPestisit zehirlenmelerinde reaktif oksijen türevlerinin artmış üretimi-ne bağlı olarak oksidatif stres geliştiği bildirilmiştir. Doku ROS seviyeleri doku hasarının en önemli göstergelerindendir. Bu çalışmada, akut organofosfat (OF) zehirlenmesinde ek olarak kullanılacak E vitamininin tedavisinin kandaki ve karaciğer dokusundaki kolin esteraz (KE) ve malondialdehit (MDA) düzeyleri üzerine etkilerini araştır-mak ve sadece antidot tedavisi verilen grup ile karşılaştırarak OF zehirlenmesi tedavisinde kullanılıp kullanılamayacağını belirlemektir. Gereç ve YöntemÇalışmada 20 Yeni Zelanda cinsi tavşan randomize olarak sham (n=8), pralidoksim (PAM)+atropin (n=6) ve E vitamini (n=6) olarak 3 gruba ayrıldı. Her denekten toksisite öncesi plazma KE, serum ve eritrosit MDA değerlerini ölçmek için kan örnekleri alındıktan sonra orogastrik yoldan 50 mg/kg 2.2-diklorvinil dimetil fosfat verildi. PAM+atropin grubundaki deneklere 30 mg/kg IV bolus, ardından 15 mg/kg PAM ve 0.05 mg/kg atropin her 4 saatte İV verildi. E vitamini grubundaki deneklere benzer atropin ve PAM tedavisine ilaveten 250 mg/kg E vitamini tek doz İM uygulandı. Deneklerden tedavi başlatıldıktan sonra 12. ve 24. saatlerde kan örnekleri alındı. Tüm deneklerden aynı parametreleri değerlendirmek üzere karaciğer dokusu örnekleri alındı. Denekler yüksek dozda İV anestezik verilerek sakrifiye edildiler. Bulgular E vitamini grubunun eritrosit MDA'sı PAM+atropin grubundan anlamlı düşük (p=0.003) tespit edildi. E vitamini grubunun karaciğer dokusundaki KE düzeyi PAM+atropin grubundan anlamlı olarak yük-sekti (p<0.001). E vitamini grubundaki tavşanların karaciğer doku MDA'sı PAM-atropin grubundan anlamlı olarak düşüktü (p<0.001). SonuçAkut OF zehirlenmesinde antidot tedavisine eklenen E vitamininin hem eritrosit ve karaciğer dokusu lipid peroksidasyonu üzeri-ne hem de karaciğer dokusu KE aktivitesi üzerine iyileştirici etkisi vardır.Anahtar sözcükler: E vitamini; kolinesteraz; malondialdehit; oksimler; organofosfor. SUMMARY Objectives Oxidative stress by increased production of reactive oxygen species has been implicated in the toxicity of many pesticides. The tissue levels of ROS are one of the most important indicator of tissue injury. The aim of this study was to examine the effects of vitamin E treatment in acute organophosphate poisoning (AOP) on choline esterase (CE) and Malondialdehit (MDA) levels in the liver tissue and blood and to compare with antidote treatment. Methods Twenty New Zaeland type rabbits were divided into randomly three groups as sham (n=8), pralidoxime (PAM)+atropine (n=6), and vitamin E (n=6

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Serum Acetylcholinesterase and Prognosis of Acute Organophosphate Poisoning

Cited by 163 publications

References 22 publications

The prognostic value of the Glasgow coma scale, serum acetylcholinesterase and leukocyte levels in acute organophosphorus poisoning

The prognostic value of the Glasgow coma scale, serum acetylcholinesterase and leukocyte levels in acute organophosphorus poisoning

Creatinephosphokinase in organophosphorus poisoning

The favorable effects of vitamin E added on treatment of experimental acute organophosphate toxicity

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