Definition:
Serum cholinesterase is a test that looks at blood levels of certain enzymes (acetylcholinesterase and pseudocholinesterase) that help the nervous system work properly. Acetylcholinesterase (also known as RBC cholinesterase) and pseudocholinesterase (also known as butyrylcholinesterase or plasma cholinesterase) help break down a chemical that nerves need to send signals. Acetylcholinesterase is found in nerve tissue and red blood cells. Pseudocholinesterase is found primarily in the liver.
Alternative Names:
Acetylcholinesterase; RBC (or erythrocyte) cholinesterase; Pseudocholinesterase; Plasma cholinesterase; Butyrylcholinesterase
How the test is performed:
Blood is drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood. Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding. In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.
How to prepare for the test:
No special preparation is necessary for this test.
How the test will feel:
When the needle is inserted to draw blood, you may feel moderate pain, or only a prick or stinging sensation. Afterward, there may be some throbbing.
Why the test is performed:
This test is done to determine if a person has been exposed to a group of chemicals known as organophosphates, which are used in pesticides. These chemicals turn off cholinesterases. The level of acetylcholinesterase and pseudocholinesterase in your blood can be used to determine your exposure and risk of toxicity. This test may also be done, although infrequently, to diagnose liver disease. It may also be ordered before a person receives anesthesia with succinylcholine, which may be given before certain procedures or treatments, including electroconvulsive therapy (ECT).
References:
Ford MD. Acute poisoning. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier. 2007: chap 111.
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