Open Access
Subscription Access
Open Access
Subscription Access
A Study of Changes in Liver Function, Pancreatic Enzyme Levels, and Creatine Phosphokinase Level in Cases of Acute Organophosphorus Poisoning
Subscribe/Renew Journal
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.
Keywords
Chemical Hepatitis, Creatine Phosphokinase, Lipase, Organophosphorus Poisoning.
User
Subscription
Login to verify subscription
Font Size
Information
- Aring C. The systemic nervous affinity of triorthocresyl phosphate (jamaica ginger palsy). Brain. 1942; 65:34–47.
- Bertolote JM, Fleischmann A, Butchart A, Besbelli N. Suicide, suicide attempts and pesticides: A major hidden public health problem. Bull World Health Organ. 2006; 84:260.
- World Health Report 2004. Geneva: WHO; 2004.
- Jeyaratnam J. Acute pesticide poisoning: A major global health problem. World Health Stat Q. 1990; 43:139–44.
- Bawaskar HS, Joshi SR. Organophosphorus poisoning in agricultural India – Status in 2005. J Assoc Physicians India. 2005; 53:422–4.
- Eddleston M. Patterns and problems of deliberate self-poisoning in the developing world. QJM. 2000; 93:715–31.
- Agarwal SB. A clinical, biochemical, neurobehavioral, and sociopsychological study of 190 patients admitted to hospital as a result of acute organophosphorus poisoning. Environ Res. 1993; 62:63–70.
- Jorens PG, Robert D, van Thielen G, van Brabant J. Impressive but classical electrocardiograph changes after organophosphate poisoning. Clin Toxicol (Phila) 2008; 46:758–9.
- Anand S, Singh S, Nahar Saikia U, Bhalla A, Sharma YP, Singh D. Cardiac abnormalities in acute organophosphate poisoning. Clin Toxicol (Phila). 2009; 47:230–5.
- Goud M, Nayal B, Deepa K, Devi OS, Devaki RN, Anitha M. A case of acute pancreatitis with occupational exposure to organophosphorus compound. Toxicol Int. 2012; 19:223–4.
- Moore PG, James OF. Acute pancreatitis induced by acute organphosphate poisoning. Postgrad Med J. 1981; 57:660–2.
- Mishra A, Pandya HV, Dave N, Mehta M. Multi-organ dysfunction syndrome with dual organophosphate pesticides poisoning. Toxicol Int. 2013; 20:275–7.
- Dressel TD, Goodale RL Jr, Zweber B, Borner JW. The effect of atropine and duct decompression on the evolution of diazinon-induced acute canine pancreatitis. Ann Surg. 1982; 195:424–34.
- Greenberger NJ, Toskes PP, Isselbacher KJ. Acute and chronic pancreatitis. In: Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, et al. editors. Harrison’s Principles of Internal Medicine. 14th ed. New York: McGraw Hill; 1998. p. 1741–52.
- Namba T. Cholinesterase inhibition by organophosphorus compounds and its clinical effects. Bull World Health Organ. 1971; 44:289–307.
- Haubenstock A, Hruby K, Jäger U. More on the triad of pancreatitis, hyperamylasemia, and hyperglycemia. JAMA. 1983; 249:1563.
- Ahmed A, Begum I, Aquil N, Atif S, Hussain T, Vohra EA. Hyperamylasemia and acute pancreatitis following organophosphate poisoning. Pak J Med Sci. 2009; 25:957–61.
- Singh S, Wig N, Chowdhury D, Sood NK, Sharma BK. Changing pattern of acute poisoning. J Assoc Physicians India. 1997; 45:194–7.
- Sahin I, Onbasi K, Sahin H, Karakaya C, Ustun Y, Noyan T. The prevalence of pancreatitis in organophosphate poisonings. Hum Exp Toxicol. 2002; 21:175–7.
- Senanayake N, Karalliedde L. Neurotoxic effects of organophosphorus insecticides. An intermediate syndrome. N Engl J Med. 1987; 316:761–3.
- Futagami K, Hirano N, Iimori E, Motomura K, Ide M, Kataoka Y, et al. Severe fenitrothion poisoning complicated by rhabdomyolysis in psychiatric patient. Acta Med Okayama. 2001; 55:129–32.
- Bhattacharyya K, Phaujdar S, Sarkar R, Mullick OS. Serum creatine phosphokinase: A probable marker of severity in organophosphorus poisoning. Toxicol Int. 2011; 18:117–23.
Abstract Views: 584
PDF Views: 0