The Cholinesterase test measures the levels of cholinesterase enzymes in the blood. These enzymes help break down acetylcholine, a chemical important for nerve function. The test is mainly used to assess liver function, pesticide poisoning, and genetic conditions affecting anesthesia response.
1️⃣ Acetylcholinesterase (AChE) / “True Cholinesterase”
Found in red blood cells, nerves, and the brain
Helps in nerve signal transmission
2️⃣ Pseudocholinesterase (Butyrylcholinesterase / BChE)
Found in liver and plasma
Helps break down certain drugs like succinylcholine (a muscle relaxant)
🔹 To check for pesticide (organophosphate) poisoning 🛑
🔹 To assess liver disease or liver damage (e.g., cirrhosis, hepatitis)
🔹 To screen for genetic pseudocholinesterase deficiency – Affects response to anesthesia
🔹 To monitor exposure to toxic chemicals – Especially in agricultural workers
| Enzyme | Normal Range |
|---|---|
| Acetylcholinesterase (AChE) | 5,000 – 10,000 U/L |
| Pseudocholinesterase (BChE) | 5,000 – 12,000 U/L |
(Ranges may vary by laboratory.)
| Cholinesterase Level | Possible Causes |
|---|---|
| Low AChE & BChE | – Organophosphate or Carbamate Poisoning (pesticides, nerve agents) – Severe Liver Disease (cirrhosis, hepatitis) – Malnutrition |
| Low BChE Only | – Genetic Pseudocholinesterase Deficiency (increased sensitivity to muscle relaxants) – Liver Damage or Failure |
| High BChE | – Liver Regeneration After Injury – Obesity or Diabetes – Certain Cancers (Lung, Breast, Prostate) |
🔹 Liver Function Tests (LFTs) – To check for liver disease
🔹 Toxicology Screening – If pesticide or chemical poisoning is suspected
🔹 Genetic Testing – If pseudocholinesterase deficiency is suspected
✅ Stop pesticide exposure (wear protective gear if working with chemicals)
✅ Monitor for liver disease (if suspected, do LFTs)
✅ Inform anesthesiologist before surgery if pseudocholinesterase deficiency is diagnosed