Study of serum cholinesterase, CPK and LDH as prognostic biomarkers in organophosphorus poisoning

  • Dr Rajdip Sen Post graduate student, Department of Medicine, SCB Medical College, Cuttack, Odisha, India
  • Dr Jadumani Nayak Associate Professor, Department of Medicine, SCB medical college, Cuttack, Odisha, India
  • Dr Sagar Khadanga Associate Professor, Department of Medicine, LN Medical College, Bhopal, Madhya Pradesh, India
DOI: https://doi.org/10.17511/ijmrr.2014.i03.03
Keywords: Cholinesterase, Creatinine Phosphokinase (CPK), Lactate dehydrogenase (LDH), Organophosphorus (OP), Peradeniya organophosphorus poisoning (POP) scale

Abstract

Introduction: Organophosphorus insecticides are arguably one of the commonest causes of morbidity and mortality due to poisoning worldwide, especially in developing countries like India due to its easy availability. This study was conducted to estimate the levels of Serum Cholinesterase, Serum Creatinine Phosphokinase & Serum Lactate Dehydrogenase on admission for correlation with severity of organophosphate poisoning and to reevaluate their levels on Day 4 and Day 8 and correlate them with the complications and final outcome of the poisoning.

Material and methods: This is a single centered cross sectional study over a period of one year.100 patients of OP poisoning were selected and their clinical severity was categorized according to Peradeniya organophosphorus poisoning (POP) scale. Level of serum Cholinesterase, serum CPK, and serum LDH were measured at admission and on Days 4 and 8.

Results: Serum Cholinesterase and CPK levels strongly correlated with clinical severity. The comparative values of serum Cholinesterase and serum LDH amongst survivors and non survivors during the course of the study was not statistically significant. The comparative values of serum Creatinine Phosphokinase between survivors and non survivors showed a statistically significant difference.

Conclusion: Serum Cholinesterase serves as a diagnostic parameter for organophosphorus poisoning and correlates with the severity but it cannot be used as a prognostic biomarker. Serum Creatinine Phosphokinase shows a strong degree of positive correlation with the severity of poisoning and can be used as a predictor of outcome in organophosphorus poisoning.

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References

1. Mancini, Francesca, Janice LS Jiggins, and Michael O'Malley. "Reducing the incidence of acute pesticide poisoning by educating farmers on integrated pest management in South India." International journal of occupational and environmental health 15.2 (2009): 143-151.

2. Cander,Ali Dur,Mesut Yidiz. The prognostic value of Glasgow Coma Scale, serum acetyl cholinesterase & leucocyte levels in acute Op poisoning. Basar Annals of Saudi Medicine 2011 Mar-Apr 31(2) 163-166.

3. David A Warrel, Timmothy M Cox, John D Firth. Oxford Text Book of Medicine 5th edition edition. 2003 ;vol 1:906-907p.

4. Edward T Bake,Rick Kellerman. Conn’s Current Therapy 2013: 1175-76p.

5. Akdur O,Durukan P,Ozkan S. Poisoning severity scale,Glasgo Coma Scale,corrected QT interval in acute OP poisoning; Department of Emergency Medicine ,Canakkale, Turkey; Human experimental toxicology 2010,May29(5)419-25. [PubMed]

6. HW Yun,DH Lee,JH Lee,YJ Cheon. Serial serum cholinesterase activities as a prognostic factor in onganophosphate poisoned patients;Hong kong journal of Emergency Medicine-Vol.19(2),Mar.2012.

7. T S Aravanapavananthan. Serum Pseudocholinesterase estimation in the management of organophosphate poisoning cases and the effect of PAM on regenerating it. Singapore Med J. 1987; Vol. 28, No. 2: 166 – 171. [PubMed]

8. Aygun D, Doganay Z, Altintop L, Guven H, Onar M, Deniz T et al. Serum acetylcholinesterase and prognosis ofacute organophosphate poisoning. J Toxicol Clin Toxicol 2002; 40: 903-910. 3. [PubMed]

9. S Agarwal, V Bhatnagar, A Agarwal, U Agarwal, K Venkaiah, S Nigam, S Kashyap. Impairment in Clinical Indices in Acute Organophosphate Insecticide Poisoning Patients in India. The Internet J of Toxicology. 2006 Volume 4 Number 1.

10. Kuntal Bhattacharyya, Sibaji Phaujdar, Rathindranath Sarkar, Omar S. Mullick. Serum Creatinine phosphokinase:A probable marker of severity in Organophosphorus poisoning Toxicol Int. 2011 Jul-Dec; 18(2): 117–123.

11. Lee WC, Yang CC, Deng JF, Wu ML, Ger J, Lin HC, Chang FY, Lee SD. The clinical significance of hyperamylasaemia in organophosphate poisoning.J Toxicol Clin Toxicol. 1998;36(7):673-81. [PubMed]

12. I Sahin,K Onbasi. The prevalence of pancreatitis in organophosphate poisonig; Department of Internal Medicine ,University of Yuzuncu,Turke; Human experimental toxicology 2000 Apr.21(4)175-177.

13. Vanneste, Yves, and Dominique Lison. "Biochemical changes associated with muscle fibre necrosis after experimental organophosphate poisoning." Human & experimental toxicology 12.5 (1993): 365-370.

14. John, M., A. Oommen, and A. Zachariah. "Muscle injury in organophosphorous poisoning and its role in the development of intermediate syndrome."Neurotoxicology 24.1 (2003): 43-53. [PubMed]

15. Senanayake, Nimal, H. J. De Silva, and Lakshman Karalliedde. "A scale to assess severity in organophosphorus intoxication: POP scale." Human & experimental toxicology 12.4 (1993): 297-299.
CITATION
DOI: 10.17511/ijmrr.2014.i03.03
Published: 2014-06-30
How to Cite
1.
Sen R, Nayak J, Khadanga S. Study of serum cholinesterase, CPK and LDH as prognostic biomarkers in organophosphorus poisoning. Int J Med Res Rev [Internet]. 2014Jun.30 [cited 2024Dec.27];2(3):185-9. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/86
Issue
Vol 2 No 3 (2014): May-Jun
Section
Original Article