What is the role of cholinesterase (ChE) level monitoring in the evaluation of organophosphate (OP) toxicity?

Updated: Dec 31, 2020
  • Author: Kenneth D Katz, MD, FAAEM, ABMT; Chief Editor: Sage W Wiener, MD  more...
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Cholinesterase levels do not always correlate with severity of clinical illness. Moreover, a variety of conditions can result in falsely lowered cholinesterase levels (see Diagnostic Considerations).

The level of cholinesterase activity is relative and is based on population estimates. Neonates and infants have baseline levels that are lower than adults. Because an individual patient's baseline levels are rarely available, the diagnosis can be confirmed by observing a progressive increase in the cholinesterase value until the values plateau over time.

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