The role of cortisol and thyroid stimulating hormone in prognosis of acute anticholinesterase pesticides poisoned patients admitted to Tanta Poison Control Center

Abstract

Introduction: Anticholinesterase poisoning is a major global health problem with thousands of deaths each year. Determination of prognosis is a major concern for clinical toxicologists. Previous studies reported that cortisol and thyroid stimulating hormone (TSH) may have prognostic role in patients poisoned by organophosphates. Aim of the work: Evaluation of prognostic role of cortisol and TSH in acute anticholinesterase pesticides poisoned patients admitted to Tanta Poison Control Center. Methodology: This prospective study included 29 patients of moderate to severe acute anticholinesterase poisoning according to poisoning severity score (PSS) between August 2019 and July 2020. TSH and serial cortisol were assessed by ELISA techniques. Results: TSH has no prognostic role, but cortisol has predictive role in mortality, need for ICU admission and intubation. Conclusion: Measuring cortisol at admission, after six and twelve hours from admission could predict need for ICU admission, intubation and mechanical ventilator, while measuring it at admission can be predictor for mortality.