Correlation between Serum Creatine Phosphokinase and Severity of Acute Organophosphorus Poisoning: A Prospective Clinical Study (2012-2013)

Organophosphorus (OP) poisoning is an important global health problem especially in developing countries like Egypt. . Estimation of erythrocyte cholinesterase (EChE) and butyrylcholinesterase (BChE) as an evidence of OP poisoning is costly, not regularly performed and shows wide inter-individual variability. Therefore, this study was designed to assess if serum creatine phosphokinase (CPK) can be used as a cheaper and easily available biomarker alternative of cholinesterase to stratify OP poisoning severity. All symptomatic patients within 6 hours of exposure to OP and without prior treatment who were admitted to Benha poisoning control unit (BPCU), Benha university hospitals, Egypt, during the period from 1 October 2012 to 31 March 2013 were enrolled in this study. The clinical severity of patients was categorized according to Peradeniya organophosphorus poisoning (POP) scale. The Glasgow coma scale (GCS), total dose of atropine "mg" and obidoxime "g" until final clinical outcome were calculated. BChE, pH and serum CPK levels were estimated following admission. ANOVA (F) test, Paired “t” test and Spearman’s correlation coefficient (rho) were used as tests of significance. The total number was 60 patients; 51.7% were mild, 33.3% were moderate and 15% were severe. There was a highly significant correlation between initial serum CPK levels and severity of acute OP poisoning. This study recommends CPK as an alternative biomarker for acute OP poisoning.