Serum cholinesterase activity may be decreased for a number of reasons.



(1) genetic phenotype associated with reduced activity (see previous section)



(1) organophosphate poisoning

(2) chronic liver disease

(3) protein malnutrition and hypoalbuminemia

(4) burns

(5) anemia

(6) acute infection

(7) myocardial infarction or heart failure

(8) acute pulmonary embolism

(9) plasmapheresis

(10) dermatomyositis

(11) muscular dystrophy

(12) chronic renal disease

(13) late pregnancy

(14) protein-losing enteropathy

(15) nephrotic syndrome

(16) exfoliative dermatitis

(17) drugs

(17a) steroids: anabolic steroids, testosterone, oral contraceptives, estrogens, glucocorticoids

(17b) neuromuscular blocking agents: pancuronium, sucinylcholine

(17c) other: phenothiazines, physostigmine, cyclophosphamide, carbamates, cimetidine, lithium, neostigmine, phenelzine, ranitidine, streptokinase


A person with a genetic phenotype associated with some reduction in activity may develop a significant reduction in activty if one of the acquired conditions is present.


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