Study of Acute Anticholinesterase Poisoning Cases and the Predictive Relevance of Caspase Markers

Objective: to assess the pattern and outcome of acute anticholinesterase poisoning cases admitted to Menoufia Poison & Control Center (MPCC) over one year and to explore the potential role of caspase markers in predicting the outcomes.Background: Acute anticholinesterase poisoning is a frequent cause of morbidity and mortality. It causes mitochondrial dysfunction, increased reactive oxygen species production, and lipid peroxidation. This increases caspase biomarker activity.Patients and methods: A prospective cohort study was done at (MPCC) over one year from (the beginning of November 2020) to (the end of October 2021). Acute anticholinesterase intoxication cases admitted to MPCC were studied. Both socio-demographic and clinical data were gathered from each patient and recorded in a clinical toxicological sheet. The cases were categorized according to peradynia organophosphorus poisoning score. Caspases 3 and 9 were measured before and after treatment.Results: This study included 68 patients. The commonest age was (20-< 30 y). Females outnumbered males (58.83 % versus 41.17 %). Regarding POP score, (45.59 %) of cases were moderate. The mortality rate constituted (8.83 %). Caspase level increased before treatment and decreased after treatment. The specificity of Caspase 3 and caspase 9 to predict mortality was (90.9 % and 93.9 % respectively), while the sensitivity of both was ( 83.3%).Conclusion: Acute anticholinesterase poisoning makes up a significant portion of all cases treated at MPCC. Caspase 3 and 9 levels increased significantly after acute anticholinesterase poisoning. Caspase markers have an important role in predicting mortality in these cases.