Pseudo Cholinesterase Enzyme Deficiency: Two Rare Cases and Treatment

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REZAEI MAHMOOD; Zolhavarieh Seyed Mohammad; Jalalvand Hassan; Hamzehei Ronak

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Journal: JOURNAL OF RESEARCH IN UROLOGY Year:2018 | Volume:2 | Issue:1 Page(s): 23-28

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Title

Pseudo Cholinesterase Enzyme Deficiency: Two Rare Cases and Treatment

Author(s)

REZAEI MAHMOOD | Zolhavarieh Seyed Mohammad | Jalalvand Hassan | Hamzehei Ronak | Issue Writer Certificate

Keywords

cholinesterase plasma

pseudo cholinesterase

succinylcholine

apnea

Abstract

Background and Objective: A deficiency of the enzyme pseudo cholinesterase (PChE) leads to slow hydrolysis of drugs having choline ester structure such as succinylcholine. The patients with this enzymatic disturbance should be provided long-term mechanical ventilation support until the return of normal muscle tonicity. Case presentation: The current study was performed on two female patients with family relation (cousins). The first operation was an emergent transurethral lithotripsy (TUL), and the second operation was an elective ovarian cystectomy. All operations were performed under general anesthesia. At the end of operations, the patients still suffered from long-time apnea and muscle weakness such that complete muscle relaxation occurred 8 h after one dose of succinylcholine. No additional dose or use of another nondepolarization muscle relaxant was required. The investigation reported a deficiency in PChE. Therefore, the patients were treated with conventional therapies, including FFP injection and newly cross-matched blood (vessel-tovessel). Conclusion: PChE deficiency is a familial trait and can occur not only in the first but also in the second generation of a family. The best treatment includes supporting mechanical ventilation and patience until complete succinylcholine hydrolysis by PChE is achieved. It is recommended to avoid using succinylcholine except for emergency situations; instead, depolarization muscle relaxants should be utilized.

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APA: Copy

REZAEI, MAHMOOD, Zolhavarieh, Seyed Mohammad, Jalalvand, Hassan, & Hamzehei, Ronak. (2018). Pseudo Cholinesterase Enzyme Deficiency: Two Rare Cases and Treatment. JOURNAL OF RESEARCH IN UROLOGY, 2(1 ), 23-28. SID. https://sid.ir/paper/267672/en

Vancouver: Copy

REZAEI MAHMOOD, Zolhavarieh Seyed Mohammad, Jalalvand Hassan, Hamzehei Ronak. Pseudo Cholinesterase Enzyme Deficiency: Two Rare Cases and Treatment. JOURNAL OF RESEARCH IN UROLOGY[Internet]. 2018;2(1 ):23-28. Available from: https://sid.ir/paper/267672/en

IEEE: Copy

MAHMOOD REZAEI, Seyed Mohammad Zolhavarieh, Hassan Jalalvand, and Ronak Hamzehei, “Pseudo Cholinesterase Enzyme Deficiency: Two Rare Cases and Treatment,” JOURNAL OF RESEARCH IN UROLOGY, vol. 2, no. 1 , pp. 23–28, 2018, [Online]. Available: https://sid.ir/paper/267672/en

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