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Current Enzyme Inhibition

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ISSN (Print): 1573-4080
ISSN (Online): 1875-6662

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Case Report

Cholinesterase Aging Phenomenon Following Acute Ethoprophos Poisoning: A Case Report

Author(s): Bilel Chefirat*, El Haouaria Touer, Nour El Houda Bensaid and Haciba Rezk-Kallah

Volume 19, Issue 1, 2023

Published on: 26 January, 2023

Page: [65 - 70] Pages: 6

DOI: 10.2174/1573408019666221221091244

Price: $65

Abstract

Background: Acute poisoning by Ethoprphos, an organophosphorus pesticide, leads to a veritable cholinergic syndrome whose diagnosis is based on the determination of cholinesterase activity. The treatment relies on the administration of atropine and pralidoxime to regenerate cholinesterases before their ageing.

Case: We report a case of a two-year-old child, hospitalized for ethoprophos poisoning, with seizures associated with tight myosis, bronchial congestion, fever, and sialorrhea. The determination of butyrylcholinesterase and acetylcholinesterase showed low rates throughout the hospitalization. Knowing that pralidoxime was introduced from the 5th day of the poisoning, these rates could be explained by aging of cholinesterases. This phenomenon is well established for organophosphate pesticides (OPs) with methylated or ethyl alkyl groups in contrast to others that are much less documented such as dipropyled OPs such as ethoprophos. The recovery of the enzyme rates was very slow with good clinical improvement.

Conclusion: Ethoprophos poisoning may cause a life-threatening prognosis with a possible phenomenon of cholinesterase aging in the absence of rapid management with administration of pralidoxime.

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[1]
Amir A, Raza A, Qureshi T, et al. Organophosphate Poisoning: demographics, severity scores and outcomes from national poisoning control centre, Karachi. Cureus 2020; 12(5)e8371
[http://dx.doi.org/10.7759/cureus.8371] [PMID: 32626615]
[2]
Robb EL, Baker MB. Organophosphate toxicity. StatPearls Publishing LLC. Treasure Island, 2020 https://www.ncbi.nlm.nih.gov/books/NBK470430/
[3]
Gupta R, Parmar M. Pralidoxime. StatPearls Publishing LLC. Treasure Island 2020. https://www.ncbi.nlm.nih.gov/books/NBK558908/
[4]
Turcant A, Dehon B, Ganiere-Monteil C, et al. Lettre à la rédaction: Diagnostic de l’intoxication aiguë par les insecticides organophosphorés basé sur la détermination de l’activité cholinestérasique. Annales de Toxicologie Analytique 2005; 17(3): 207-9.
[http://dx.doi.org/10.1051/ata:2005021]
[5]
Braitberg G. Drugs and antidotes in acute intoxication. In: Ronco C, Bellomo R, Kellum JA, Ricci Z, Eds. Critical Care Nephrology. 3rd ed. Elseviers Amsterdam, 2019; p. pp. 574-88.
[http://dx.doi.org/10.1016/B978-0-323-44942-7.00098-4]
[6]
Jokanović M. Medical treatment of acute poisoning with organophosphorus and carbamate pesticides. Toxicol Lett 2009; 190(2): 107-15.
[http://dx.doi.org/10.1016/j.toxlet.2009.07.025] [PMID: 19651196]
[7]
Zhuang Q, Young A, Callam CS, et al. Efforts toward treatments against aging of organophosphorus-inhibited acetylcholinesterase. Ann N Y Acad Sci 2016; 1374(1): 94-104.
[http://dx.doi.org/10.1111/nyas.13124] [PMID: 27327269]
[8]
Chowdhary S, Bhattacharyya R, Banerjee D. Acute organophosphorus poisoning. Clin Chim Acta 2014; 431: 66-76.
[http://dx.doi.org/10.1016/j.cca.2014.01.024] [PMID: 24508992]
[9]
World Health Organization. Division of vector biology and control. Ethoprophos 1988. Available from: https://apps.who.int/iris/handle/10665/61270
[10]
Arena M, Auteri D, Barmaz S, et al. Peer review of the pesticide risk assessment of the active substance ethoprophos. EFSA J 2018; 16(10)e05290
[PMID: 32625701]
[11]
National Agency for Food, Environmental and Occupational Health Safety (ANSES). File no. 2013-1239: MOCAP 15g 2014. Available from: https://www.anses.fr/fr/system/files/phyto/evaluations/MOCAP15G_PMUT_2013-1239_Ans.pdf
[12]
Roger C, Stanton R, Joyce F, et al. Medical toxicology and worker health and safety. Ethoprop risk characterization document. In: Branches Department of Pesticide Regulation California Environmental Protection Agency. 1995.
[13]
Pohanish R. Pesticides and agricultural chemicals. (2nd ed.), Elsevier 2015.
[14]
Cardon N, Vaillant C, Cren P, Gruffat B, Rappold JP, Corbé H. Intoxication aiguë au pesticide organophosphoré et activités des cholinestérases. Ann Biol Clin 2005; 63(3): 329-34.
[PMID: 15951267]
[15]
Raveendra KR, Mohan CN, Nandan K. A study to assess the utility of Peradeniya Organophosphorous Poisoning (POP) scale, Poisoning Severity Score (PSS) and Glasgow Coma Scale (GCS) in predicting severity and treatment outcome in acute organophosphorous poisoning. Int J Contemp Med Res 2020; 7(2): B20-4.
[http://dx.doi.org/10.21276/ijcmr.2020.7.2.22]
[16]
Chandrasekhar S, Rahim MA, Quraishi SMS, Theja RC, Sai Kiran K. An observational clinical study of assessing the utility of PSS (poison severity score) and GCS (Glasgow coma scale) scoring systems in predicting severity and clinical outcomes in OP poisoning. J Evid Based Med Healthcare 2017; 4(38): 2325-32.
[http://dx.doi.org/10.18410/jebmh/2017/458]
[17]
Goullé JP, Droy JM, Leroy JP. Analytical responses to cholinergic and anticholinergic syndromes. Annal Analytical Toxicol 2000; 12(4): 282-95.
[http://dx.doi.org/10.1051/ata/2000003]
[18]
Fareed M, Pathak MK, Bihari V, Kamal R, Srivastava AK, Kesavachandran CN. Adverse respiratory health and hematological alterations among agricultural workers occupationally exposed to organophosphate pesticides: a cross-sectional study in North India. PLoS One 2013; 8(7)e69755
[http://dx.doi.org/10.1371/journal.pone.0069755] [PMID: 23936093]
[19]
Costa G, Petit A. Childhood thrombocytosis. Elsevier Amsterdam 2019.
[http://dx.doi.org/10.1016/S2588-932X(19)30189-5]
[20]
Thabet H, Brahmi N, Kouraïchi N, Elghord H, Amamou M. Intoxications par les pesticides organophosphorés: nouveaux concepts. Resuscitation 2009; 18(7): 633-9.
[http://dx.doi.org/10.1016/j.reaurg.2009.05.006]
[21]
Li H, Schopfer LM, Nachon F, Froment MT, Masson P, Lockridge O. Aging pathways for organophosphate-inhibited human butyrylcholinesterase, including novel pathways for isomalathion, resolved by mass spectrometry. Toxicol Sci 2007; 100(1): 136-45.
[http://dx.doi.org/10.1093/toxsci/kfm215] [PMID: 17698511]
[22]
Bajracharya SR, Prasad PN, Ghimire R. Management of organophosphorus poisoning. J Nepal Health Res Counc 2016; 14(34): 131-8.
[PMID: 28327676]
[23]
Worek F, Thiermann H, Wille T. Oximes in organophosphate poisoning: 60 years of hope and despair. Chem Biol Interact 2016; 259(Pt B): 93-8.
[http://dx.doi.org/10.1016/j.cbi.2016.04.032] [PMID: 27125761]
[24]
Lotti M. Chapter 72: Clinical toxicology of anticholinesterase agents in humans. In: Krieger R, Ed. Hayes’ Handbook of Pesticide Toxicology. Academic Press: Cambridge, 2010; pp. 1543-89.
[http://dx.doi.org/10.1016/B978-0-12-374367-1.00072-0]
[25]
Franjesevic AJ, Sillart SB, Beck JM, Vyas S, Callam CS, Hadad CM. Resurrection and reactivation of acetylcholinesterase and butyrylcholinesterase. Chemistry 2019; 25(21): 5337-71.
[http://dx.doi.org/10.1002/chem.201805075] [PMID: 30444932]
[26]
Reigart JR, Roberts JR. Chapter 5: organophosphate insecticides. In: Recognition and management of pesticide poisonings 6th ed. United States Environmental Protection Agency (USEPA). 2013.
[27]
Johnson MK, Jacobsen D, Meredith TJ, et al. Evaluation of antidotes for poisoning by organophosphorus pesticides. Emerg Med Australas 2000; 12(1): 22-37.
[http://dx.doi.org/10.1046/j.1442-2026.2000.00087.x]
[28]
Marrs TC, Vale JA. Chapter 49: management of op pesticide poisoning. In: Gupta R, Ed. Toxicology of organophosphate and carbamate compounds. Elsevier Academic Press 2006; pp. 715-33.

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