Pseudocholinesterase Enzyme Deficiency in Adıyaman City Area

Abstract

Objective: Pseudocholinesterase (PChE) is an enzyme responsible for the hydrolysis of succinylcholine. In case of its deficiency, the effect of succinylcholine that is approximately 5-10 min is prolonged up to few hours. The use of succinylcholine has been declined recently. However, it is still actively used in some special conditions and in developing countries. In this study, incidence of PChE enzyme deficiency around Adiyaman city was investigated and presented with the literature review. Methods: After obtaining an approval from the investigational board of our hospital (Adiyaman University Medical School, Biomedical Research Ethics Board, 30.12.2012, Nr: B.30.2.ADY.0.20.00-600/51), patients undergoing any elective operation under general anaesthesia in the Adiyaman University Medical School Hospital between March and December 2013 were recruited for the study. After obtaining the patients' written consents, blood PChE, alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea, creatinine, international normalisation ratio (INR) and activated partial thromboplastin time (aPTT) values of the patients were analysed. Possible association of the PChE deficiency with other values was also investigated. The normal value of PChE was taken as 4260-11250 for females aged 16-40 years and 5320-12920 U L −1 for other patients. Results:The study was completed with 964 patients, 702 (72.8%) of whom were females. PChE enzyme levels were under the normal in 7.2% of the patients. There were no correlation between patient group, ALT, INR, aPTT and creatinine elevation with PChE deficiency (p>0.05), whereas AST and urea level elevation was significantly associated with PChE deficiency (p<0.05). The risk of PChE deficiency was 4.5 and 9 times higher in the patients with the elevation of AST and urea levels, respectively. Conclusion:Pathological elevations of AST and urea that are a part of normal pre-operative biochemical analysis of blood will indicate the possible deficiency of PChE enzyme. AbstractThis study was presented orally in

Prevalence of human pseudocholinesterase (butyrylcholinesterase) deficiency in central Anatolian people: A cross-sectional study

“…PChE activity is not significantly correlated with liver function tests, which can be derived from the advanced liver failure patients who were excluded from this study. A recent study conducted by Abdullayev et al [24], investigating the likely relationship between pseudocholinesterase deficiency and other laboratory tests, revealed a significant relationship between AST, urea levels and PChE. However, they could not detect any relationship between PChE and ALT, INR, aPTT and creatinine levels.…”

Suxamethonium Apnoea : The Forgotten Episode in Current Practice

“…The causes of suxamethonium apnea are both hereditary and/or acquired. Genetically, BCHE gene codes for PChE are located on the chromosome 3p26.1 to 26.2 1,11,12 . Any mutation in this gene would result in an autosomal recessive disorder.…”

“…However, caution is advised, as blood transfusions in PChE deficient patients carry all the risks and complications of blood transfusion. The only well-founded management of suxamethonium apnea is to wait for the patient's spontaneous recovery 1,12 . A promising animal study of plant-derived recombinant PChE reverses the suxamethonium-induced apnea 19 .…”