title: Reduced pseudocholinesterase activity in patients with HELLP syndrome.
abstract: The authors previously reported a case of decreased pseudocholinesterase activity in a patient with HELLP syndrome. It was assumed that the reduced pseudocholinesterase activity in HELLP syndrome is associated with impaired liver function. The present study assesses the prevalence of low pseudocholinesterase in patients with HELLP syndrome. Serum pseudocholinesterase activity was determined with spectrophotometer in 15 patients with HELLP syndrome. Two control groups matched for gestational age were recruited: 15 healthy women with uncomplicated pregnancy and 15 women with severe preeclampsia without HELLP. The prevalence of reduced pseudocholinesterase activity lower than normal limit was 60.0% (9/15) in patients with HELLP syndrome, 33.3% (5/15) in patients with severe preeclampsia, and 6.6% (1/15) in women with normal pregnancy, respectively (P =.009). The pseudocholinesterase activity was found to correlate with serum alanine aminotransferase levels (r = 0.417, P = .006) and with serum aspartate aminotransferase levels (r = 0.462, P = .002). Considering the increased prevalence of reduced pseudocholinesterase activity in patients with HELLP syndrome, the authors suggest that whenever general anesthesia is applied in these patients, the anesthesiologist should be aware that the patient may show slow metabolic degradation of choline-ester drugs.
authors.affiliation: Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel. lurie@nashim.net
authors.forename: Samuel
authors.initials: S
authors.lastname: Lurie
authors.forename: Oscar
authors.initials: O
authors.lastname: Sadan
authors.forename: Galia
authors.initials: G
authors.lastname: Oron
authors.forename: Asora
authors.initials: A
authors.lastname: Fux
authors.forename: Mona
authors.initials: M
authors.lastname: Boaz
authors.forename: Tiberiu
authors.initials: T
authors.lastname: Ezri
authors.forename: Abraham
authors.initials: A
authors.lastname: Golan
authors.forename: Jacob
authors.initials: J
authors.lastname: Bar
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D000768:Anesthesia, General / Q000379:methods; D001219:Aspartate Aminotransferases / Q000097:blood*; D002091:Butyrylcholinesterase / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D017359:HELLP Syndrome / Q000097:blood / Q000201:enzymology* / Q000453:epidemiology; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood / Q000201:enzymology*; D011247:Pregnancy / Q000097:blood; D011248:Pregnancy Complications; D015995:Prevalence; D011446:Prospective Studies; D013053:Spectrophotometry
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D002091:Butyrylcholinesterase