Clinical significance of serum amylase and glucose level in organophosphorus poisoning

Abstract

Background: Organophosphorous(OP) poisoning is a
common problem in country like Nepal where agriculture
is the backbone of the economy. The primary mechanism
of action is inhibition of acetylcholinesterase(ACHE).
Organophosphorus poisoning is a possible cause of acute
pancreatitis along with alternation of glucose metabolism.

Materials and Method: This was a hospital based cross-
sectional comparative study. The level of serum amylase

and glucose were measured in thirty-eight OP poisoned
patients at the time of admission, before discharge and
were compared.

Results: Amongst 38 patients, Majority
had mild OP poisoning 27(71.1%) as per Peradeniya
Organophosphorus Poisonin(POP) score whereas
9(23.7%) had moderate and 2(5.2%) had severe poisoning.
The mean initial serum amylase level in patients with mild
poisoning was 152±73.92 (IU/L)(p=0.000), in moderate
poisoning was 213.38±69.39 (IU/L) (p=0.223) and in
severe poisoning was 171.33±107.22(IU/L) (p=0.259).
There was increase in serum amylase level in all patients
with poisoning but level did not increase in proportion
to increase with severity of POP score. The mean initial
serum glucose level in mild poisoning was 132.48±37.73
(Mg/dl) (p=0.024), in moderate poisoning was 139±44.59
(Mg/dl) (p=0.033) and in severe poisoning was 174±23.38
(Mg/dl)(p=0.22). The serum glucose level increased as the
severity of POP score increased. The serum amylase and
glucose levels in recovering patients showed a tendency to
decrease to their normal values. No patient had developed
acute symptomatic pancreatitis.

Conclusion: Serum mylase and glucose level were increased in all patients
with OP poisoning but didn’t correlate with the clinical
severity. Routine measurement of serum amylase in
patients of OP poisoning has little value in the absence of
clinical acute pancreatitis.