A Study of Changes in Liver Function, Pancreatic Enzyme Levels, and Creatine Phosphokinase Level in Cases of Acute Organophosphorus Poisoning

Abstract

Organophosphorus (OP) compounds are widely used insecticides in this part of the world. Organophosphorus compounds are responsible for a majority of suicidal attempt in India due to its easy availability. To determine the effect of organophosphorus compounds on hepatobiliary, pancreas, and muscular system and association of biochemical markers of respective systems to determine the outcome. This is a single-center, observational, prospective study conducted on 150 organophosphorus (OP) poisoning patients diagnosed clinically and with circumferential evidence. After admission, relevant biochemical markers of respective systems were done with standard guidelines. In patients where abnormality was found in serum amylase and lipase levels, ultrasonography and/or contrast-enhanced computed tomography evaluation of abdominal organs was done as per clinical indication. Among 150 patients, 17 (11.33%) patients succumbed to death. A significant association was observed between lipase level and treatment outcome. The odds ratio of death among high-level lipase group was 11.54 times higher than normal lipase group. Only four patients developed isolated creatine phosphokinase elevation with features suggestive of rhabdomyolysis. Isolated hepatic enzyme derangements found in only one case, whereas 5 patients had concurrent elevated lipase level. Organophosphorus-induced pancreatitis with or without hepatitis is often overlooked in acute poisoning which may be fatal. An early intervention often reverses this dreaded complication.