Alternate Biochemical Markers in Organophosphate Poisoning

In India, organophosphates are the most widely used pesticides for suicide by poisoning. Early recognition of the diagnosis and its severity will help in achieving a better outcome. In poisoning by organophosphorus compounds, serum acetylcholinesterase (AChE) and pseudocholinesterase are currently widely accepted as biochemical markers for estimating the severity. A wide array of alternate, cheap, and easily available markers are explored in this review and using a combination of these markers may be better in terms of early identification of severe poisoning. In peripheral centers without access to costly investigations, these cheap markers may help in guiding an early referral to higher centers for severely poisoned patients. A comprehensive study comparing all these different markers has not been done so far, thereby emphasizing the need for the same. This review identified various new, cheaper, and easily available biochemical markers as having the potential to act as surrogates for assessing the severity of organophosphate poisoning, and there is a scope for future studies to understand its utility.