Plasma Cholinesterase Test; Butyrylcholinesterase

Why is a cholinesterase test done?

• Your health care provider may order this test if you may have been exposed to chemicals called organophosphates. These chemicals are used in pesticides. This test can help determine your risk of poisoning.

What does a low cholinesterase level indicate?

• Significantly decreased cholinesterase activity levels usually indicate excessive absorption of organophosphate compounds. Pseudocholinesterase and RBC acetylcholinesterase activity are usually decreased within a few minutes to hours after exposure.

What is the normal cholinesterase level?

• Normal Results
• Typically, normal pseudocholinesterase values range between 8 and 18 units per milliliter (U/mL) or 8 and 18 kilounits per liter (kU/L). Note: Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.

What happens when cholinesterase is high?

• If these chemicals get into your body, they can affect how you breathe and can cause general muscle weakness?. They are called cholinesterase inhibitors. An overdose of these chemicals can be fatal.

What can cause low cholinesterase?

• Reduced cholinesterase levels can also be caused by chronic liver disease and malnutrition. Total cholinesterase activity can be lowered in a number of other conditions, including pregnancy, renal? disease, shock?, and some cancers.

How is low cholinesterase treated?

• There is no cure for pseudocholinesterase deficiency. If you have the condition and you receive muscle relaxants that prolong your anesthesia recovery, you’ll likely need medical assistance. If needed, mechanical ventilation support and sedation are provided while you recover and start breathing on your own.

What causes high cholinesterase?

• Several conditions are associated with increases in plasma cholinesterase activity, including thyroid? disease, obesity, nephrotic syndrome?, and cognitively challenged children.

When should a blood test for baseline? cholinesterase be done?

• When obtaining the 2nd baseline, wait to test until at least 3 days after the baseline, but within 30 days, and ensure no pesticide exposures during this time period. Measure both acetylcholinesterase (red blood cell cholinesterase-AChE) and butyrylcholinesterase (plasma cholinesterase-PC).

How is cholinesterase measured?

• How is a cholinesterase test performed? Cholinesterase is a blood test and requires a few milliliters of blood from a vein. The laboratory may measure the levels of cholinesterase enzyme activity in the plasma or red blood cells or both.

Where is cholinesterase produced?

• In the liver
• Cholinesterase is a plasma enzyme, produced by the liver, which is capable of hydrolyzing a variety of choline esters. Plasma activity falls with decreased protein synthesis in liver disease. Enzyme levels generally follow a path similar to that of plasma albumin.

What are the side effects of cholinesterase inhibitors?

• The most common adverse effects of cholinesterase inhibitors include nausea?, diarrhea?, vomiting?, decreased appetite, dyspepsia?, anorexia, muscle cramps, fatigue?, insomnia, dizziness?, headache?, and asthenia. 1–3 Taking these medications with food, preferably a full meal, can mitigate these gastrointestinal effects.

Is cholinesterase affected by pH?

• With most substrates, the enzyme activity increased from pH 5 to pH 10 and decreased at pH 11. Acetylcholine and acetyl-β-methacholine showed an activity maximum at pH 7 or 8. Inhibition by the selective inhibitor of specific cholinesterase 284 C 51 was not markedly affected by pH.