Pseudocholinesterase, Total


Sunquest Code:PSEUD  
Epic Code:LAB965Epic Name:PSEUDOCHOLINESTERASE
Synonyms:Cholinesterase, Serum or Plasma
Methodology:Enzymatic
CPT Code:82480
Turnaround Time:Specimens are sent to reference laboratory Mon-Sat; results are reported in 1-4 days.


Collection Instructions

Specimen:Blood
Optimal Volume:1 mL
Minimum\Peds Volume:0.4 mL
Container:Red (no gel) (Green (lithium heparin, gel), Green (sodium heparin, no gel), Purple (EDTA), Red or gold (gel))
Collection Instructions:Sample must be drawn prior to surgery or 2 days post. Do not collect in recovery room.
Causes for Rejection:Hemolysis


Processing and Shipping

Specimen Processing:Centrifuge and aliquot 0.5 mL, 0.1 mL minimum. Separate serum or plasma from cells ASAP. Store in refrigerator.
Shipping Instructions:Ship at refrigerated temperature.
Test Performed at or Referral Lab Lab Sendouts  (ARUP)
Referral Lab number:20167 (CHE-P)


Interpretive

Reference Range:2900-7100 U/L. Plasma values are slightly lower than serum.
Use:

True cholinesterase is found in RBCs and nervous tissues. Pseudocholinesterase is found in the plasma. In acute insecticide poisoning, the total cholinesterase (RBC and plasma) will be markedly reduced. Symptoms begin to appear at about 60% of normal activity and serious neuromuscular effects are seen at about 20% of normal. Total whole blood cholinesterase may be used as a screening test for acute and chronic exposure. Specific levels for RBC versus plasma cholinesterase differentiate exposure and recovery states. Levels are also decreased in liver disease (acute hepatitis, chronic hepatitis, cirrhosis, carcinoma) organophosphate poisoning, chronic renal disease, late stages of pregnancy and estrogen therapy.

 

Some patients have atypical enzyme variants that are unable to hydrolyze succinylcholine that will cause prolonged response and apnea if exposed to succinycholine during anesthesia. Low levels or even the absence of serum cholinesterase is indicative of atypical variants.

 



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