Evaluation of Cases with Acute Cholinesterase Inhibitor Pesticide Toxicity Through Blood Pseudocholinesterase and Inflammatory Biomarkers

Background: Organophosphorus and carbamate compounds are cholinesterase inhibitor Pesticides. These compounds are extensively employed in agriculture in Egypt and other developing countries. They represent a major cause of acute poisoning worldwide with increasing number of morbidity and mortality. They work mainly by blocking cholinesterase enzyme. Also, they can result in extensive body inflammatory reaction. In this study, we aimed for early prediction of severity and outcome in acute cholinesterase inhibitor pesticide poisoning cases to help improving the course of management and deciding the best way of care. Methods: A prospective cross-sectional study was carried out on fifty-seven cases of acute cholinesterase inhibitor pesticides poisoning who came to the emergency department then admitted either to the Poisoning Treatment Unit or Intensive Care Unit (ICU) at Zagazig University Hospitals. Blood Pseudocholinesterase and inflammatory biomarkers were measured in all cases. Results: There was a statistically significant difference between pseudocholinesterase enzyme level and outcome of patients. Also, there was a statistically significant difference between haematological inflammatory indices (NLR,MLR,NLPR,SII,SIRI and AISI) and cytokines (TNF-α and IL-10) and the outcome of patients, while there is no statistically significant difference between haematological inflammatory index (PLR) and the outcome of patients. Conclusion: Pseudocholinesterase enzyme level, haematological inflammatory indices (NLR-NLPR- MLR-SII-SIRI and AISI) and cytokines (TNF-α and IL-10) can be used as early predictors of outcome in patients with acute cholinesterase inhibitor pesticides toxicity, and they can be used to determine whether those patients should be admitted to the Poisoning Treatment Unit or ICU.