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Cholinesterase, Serum
Test Code37965
CPT Codes
82480<br><strong>**This test is not available for California patients. For California patient testing, use 90371.**</strong>
Preferred Specimen
1 mL serum
Minimum Volume
0.5 mL
Instructions
Centrifuge and transfer serum specimens to clean, plastic, screw-capped vial(s)
Transport Temperature
Refrigerated (cold packs)
Specimen Stability
Room temperature: 21 days
Refrigerated: 21 days
Frozen: 30 days
Refrigerated: 21 days
Frozen: 30 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Hemolysis
Methodology
Spectrophotometric Kinetic
FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics Nichols Institute. 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
A.M. Sets up 5 days a week.
Limitations
Results may be depressed in patients who consume oral contraceptives. Hepatic disease may cause up to a 70% decrease in enzyme levels. Cholinesterase may be slightly elevated in patients with obesity or diabetes.
Clinical Significance
This test may be used to detect exposure to or poisoning from organophosphate-based pesticides; to assess baseline levels before exposure to organophosphates; or to monitor cholinesterase levels in individuals who work with pesticides. This test is also used in the diagnosis of inherited pseudocholinesterase deficiency, for individuals with a family history who will be receiving the muscle relaxant succinylcholine during surgery [1].
The Cholinesterase, Serum assay is often used as part of the diagnostic evaluation for individuals who present with symptoms of pesticide poisoning. Symptoms of organophosphate poisoning can range from mild to severe and may include sweating, salivation, miosis, hypotension, urinary incontinence, mental confusion, gastrointestinal spasms, anxiety, insomnia, tremors, convulsions, respiratory depression, and circulatory collapse, among others [1,2].
This test is also used in the diagnosis of inherited pseudocholinesterase deficiency, an enzyme deficiency characterized by impaired metabolism of succinylcholine, a muscle relaxant for surgical anesthesia. Individuals with this disorder who receive succinylcholine are at risk for prolonged postsurgical apnea and paralysis lasting 2 or more hours [3]. Thus, testing may be helpful to evaluate individuals who present with these symptoms postsurgically, as well as those with a family history of pseudocholinesterase deficiency who are scheduled for surgery [1].
References
1. American Association of Clinical Chemistry. Cholinesterase tests. https://labtestsonline.org/tests/cholinesterase-tests. Accessed September 24, 2019.
2. Lessenger JE, Reese BE. J Am Board Fam Pract. 1999;12:307-314.
3. Soliday FK, et al. AANA J. 2010;78:313-320.
The Cholinesterase, Serum assay is often used as part of the diagnostic evaluation for individuals who present with symptoms of pesticide poisoning. Symptoms of organophosphate poisoning can range from mild to severe and may include sweating, salivation, miosis, hypotension, urinary incontinence, mental confusion, gastrointestinal spasms, anxiety, insomnia, tremors, convulsions, respiratory depression, and circulatory collapse, among others [1,2].
This test is also used in the diagnosis of inherited pseudocholinesterase deficiency, an enzyme deficiency characterized by impaired metabolism of succinylcholine, a muscle relaxant for surgical anesthesia. Individuals with this disorder who receive succinylcholine are at risk for prolonged postsurgical apnea and paralysis lasting 2 or more hours [3]. Thus, testing may be helpful to evaluate individuals who present with these symptoms postsurgically, as well as those with a family history of pseudocholinesterase deficiency who are scheduled for surgery [1].
References
1. American Association of Clinical Chemistry. Cholinesterase tests. https://labtestsonline.org/tests/cholinesterase-tests. Accessed September 24, 2019.
2. Lessenger JE, Reese BE. J Am Board Fam Pract. 1999;12:307-314.
3. Soliday FK, et al. AANA J. 2010;78:313-320.
