Cholinesterase, Serum, with Dibucaine Inhibition

Test Code

7961

CPT Codes
82480, 82638

Preferred Specimen

1 mL serum

Minimum Volume

0.5 mL

Transport Container

Plastic screw-cap vial

Transport Temperature

Room temperature

Specimen Stability

Room temperature: 21 days
Refrigerated: 21 days
Frozen: 30 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Gross hemolysis

Methodology
Kinetic Spectrophotometric (KS)

FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule

Set up: Daily; Report available: 1 day

Limitations

Elevated values, caused by the presence of young RBCs and reticulocytes, may mask acetylcholinesterase inhibition.

Reference Range

Cholinesterase, Serum
Male	3342-7586 IU/L
Female	2673-6592 IU/L
Dibucaine Number	81.6-88.3 % Inhibition

Cholinesterase with Dibucaine Inhibition

Phenotype	% Inhibition
U	83.6
A*	19.9
AS*	20.7
S1*	5.3
S2*	67.6
F*	71.8
AF*	60.2
FS*	76.7
UA	72.7
UF	79.8
US	84.4

* Phenotype reportedly associated with prolonged apnea.

Clinical Significance

The Pseudocholinesterase phenotype can be determined by analysis of Pseudocholinesterase and the percent inhibition by Dibucaine. Approximately 96% of the population has normal activity, approximately 4% will exhibit decreased activity that leads to prolonged paralysis following use of succinylcholine, and 1 in 3000 patients will exhibit severe, prolonged paralysis following anesthetic exposure.

Performing Laboratory

Quest Diagnostics Nichols Institute

14225 Newbrook Drive

Chantilly, VA 20153

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.