Serum pseudocholinesterase measurement monitors exposure to organophosphate insecticides, patients with liver disease, and patients with low pseudocholinesterase levels due to specific genes.
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Two enzymes hydrolyze acetylcholine (ACH): acetylcholinesterase or true cholinesterase and pseudocholinesterase or serum cholinesterase. Acetylcholinesterase, found in the brain's nerve tissue, spleen, and gray matter, helps transmit nerve impulses from nerve endings to muscle fibers. Pseudocholinesterase, mainly produced in the liver, is found in small amounts in the pancreas, intestine, heart, and brain's white matter.
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 nerve gas. Muscle relaxants, such as succinylcholine, are usually destroyed by pseudocholinesterase. If pseudocholinesterase is absent, the patient may experience a prolonged period of apnea if muscle relaxation is given 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, cirrhosis with jaundice, dermatomyositis, hepatitis, inability to hydrolyze muscle relaxants during surgery, infectious mononucleosis, metastasis, myocardial infarction, organophosphate insecticide poisoning, tuberculosis, uremia. Medications: Atropine, caffeine, chloroquine hydrochloride, codeine, cyclophosphamide, estrogens, folic acid, MAO inhibitors, morphine sulfate, neostigmine, oral contraceptives, phenothiazines, physostigmine, iodine, pyridostigmine bromide, quinidine, quinine sulfate, succinylcholine, theophylline, vitamin K
Important Note
Laboratory test results are the most critical parameter for diagnosing and monitoring all pathological conditions. Between 70 to 80% of diagnostic decisions are based on laboratory tests. Correctly interpreting 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 analyzed based on each case and family history, clinical findings, and the results of other laboratory tests and information. Your 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 contact your doctor to ensure you receive the best possible medical care.
