Study of serum amylase levels in organophosphate poisoning

Abstract

Background: Organophosphorus is poisoning producing clinical alterations in the serum amylase and lipase activity. Earlier plasma cholinesterase level was used to assess the severity of poisoning. Presently serum amylase is being recommended as a better indicator of severity. Aims and Objectives: The present study was undertaken to estimate serum amylase levels in acute organophosphate poisoning andto correlate serum amylase levels with outcome of patient . Methods : This cross sectional study was conducted in Shri Vasantrao Naik Government Medical College and Hospital, Yavatmal. A total of 120 patients with organophosphorus poisoning admitted to the hospital during the study period of 1st January 2017 to 30 th November 2017 were included in the study. Biochemical evaluation which includes serum amylase, blood glucose, urea, creatinine, and liver function tests were analyzed. Results: In OP poisoning patients , the amylase levels were significantly elevated at the time of admission (178.21 U/L) and have shown a gradual remission with proper treatment. The mean amylase level in severely poisoned patients was 294.8 U/L. The bad prognostic factors, very well correlated with serum amylase levels were Pinpoint pupil- 297 U/L, Fasciculations-309 U/L, Severe secretions-321 U/L, CNS depession-334 U/L, Respiratory failure-359 U/L and Convulsions-398 U/L. The overall mean value of serum amylase was significantly higher in non-survivors Vs survivors (482.46 U/L Vs 148.34 U/L, p<0.0001). Conclusion: Serum amylase levels may be considered as a marker of Organophosphorous intoxication, since it enables the early recognition of severity and to identify those at risk of developing the complications of Organophosphorous poisoning.