Clinical significance of serum amylase and glucose level in organophosphorus poisoning

Background: Organophosphorous(OP) poisoning is acommon problem in country like Nepal where agricultureis the backbone of the economy. The primary mechanismof action is inhibition of acetylcholinesterase(ACHE).Organophosphorus poisoning is a possible cause of acutepancreatitis 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 poisonedpatients at the time of admission, before discharge andwere compared. Results: Amongst 38 patients, Majorityhad mild OP poisoning 27(71.1%) as per PeradeniyaOrganophosphorus Poisonin(POP) score whereas9(23.7%) had moderate and 2(5.2%) had severe poisoning.The mean initial serum amylase level in patients with mildpoisoning was 152±73.92 (IU/L)(p=0.000), in moderatepoisoning was 213.38±69.39 (IU/L) (p=0.223) and insevere poisoning was 171.33±107.22(IU/L) (p=0.259).There was increase in serum amylase level in all patientswith poisoning but level did not increase in proportionto increase with severity of POP score. The mean initialserum 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 theseverity of POP score increased. The serum amylase andglucose levels in recovering patients showed a tendency todecrease to their normal values. No patient had developedacute symptomatic pancreatitis. Conclusion: Serum mylase and glucose level were increased in all patientswith OP poisoning but didn’t correlate with the clinicalseverity. Routine measurement of serum amylase inpatients of OP poisoning has little value in the absence ofclinical acute pancreatitis.