Serum pseudocholinesterase measurement is used to monitor exposure to organophosphate insecticides, to monitor patients with liver disease, and to identify patients with low pseudocholinesterase levels due to the presence of specific genes.
There are two enzymes that hydrolyze acetylcholine (ACH): acetylcholinesterase or true cholinesterase, and pseudocholinesterase or serum cholinesterase. Acetylcholinesterase, which is found in the nerve tissue, spleen and gray matter of the brain, helps transmit nerve impulses from nerve endings to muscle fibers. Pseudocholinesterase, which is mainly produced in the liver, is found in small amounts in the pancreas, intestine, heart and white matter of the brain.
Two groups of chemical anticholinesterases, organophosphates and muscle relaxants, either affect or are affected by these enzymes. Organophosphates, which inactivate acetylcholinesterase, are found in many insecticides and in nerve gas. Muscle relaxants, such as succinylcholine, are usually destroyed by pseudocholinesterase. If, however, there is a lack of pseudocholinesterase, the patient may experience a prolonged period of apnea if given muscle relaxation during surgery. Thus, patients who are to receive such drugs during surgery should be screened for cholinesterase.
Possible Interpretations of Pathological Values
- Decrease: Acute infections, anemia, chronic malnutrition, jaundice cirrhosis, dermatomyositis, hepatitis, failure to hydrolyse muscle relaxants during surgery, infectious mononucleosis, metastasis, infarction Medications: Atropine, Caffeine, Chloroquine hydrochloride, Codeine, Cyclophosphamide, Estrogen, Folic acid, MAO inhibitors, Morphine sulfate, Neostigmine, Oral contraceptives, Phenothiazine, Buccinosine, Physostigmine, vitamin K
Laboratory test results are the most important parameter for the diagnosis and monitoring of all pathological conditions. 70%-80% of diagnostic decisions are based on laboratory tests. Correct interpretation of laboratory results allows a doctor to distinguish "healthy" from "diseased".
Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be interpreted in relation to each individual case and family history, clinical findings and the results of other laboratory tests and information. Your personal physician should explain the importance of your test results.
At Diagnostiki Athinon we answer any questions you may have about the test you perform in our laboratory and we contact your doctor to get the best possible medical care.