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22271 Acetylcholinesterase, Erythrocytes (ACHS)

Acetylcholinesterase, Erythrocytes (ACHS)
Test Code: ACHSSO
Synonyms/Keywords
​Carbamates, Cholinesterase, Insecticide Poisoning, Organo-Phosphate Poisoning, RBC Acetyl Cholinesterase
Useful For
​Detecting effects of chronic or remote (months) past exposure to cholinesterase inhibitors (organophosphate insecticide poisoning)
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Whole blood EDTA Lavender Top Tube (LTT)​ 4 mL​ 2.5 mL​
Collection Processing Instructions

​Specimen must arrive within 72 hours of draw. Date of draw is required.

Send whole blood specimen in original tube.  Do not aliquot. 

Specimen Stability Information
Specimen Type Temperature​Time
​Whole blood Refrigerated (preferred)​​72 hours
Rejection Criteria
Gross hemolysis
Interference

​Make sure the potential offending agent is, indeed, an acetylcholinesterase inhibitor. 

Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available Methodology/Instrumentation
Mayo Clinic Laboratories
 Wednesday 4 to 8 days​
Spectrophotometric-Thiocholine Production​
Reference Lab
Test Information

Erythrocyte acetylcholinesterase (AChE) activity is measured to evaluate possible exposure to organophosphate insecticides. Organophosphates act by irreversible inhibition of AChE. Inhibition of AChE in humans causes a variety of acute symptoms including dizziness, nausea, difficulty breathing, and even death. The presence and severity of these symptoms depend, in part, on the degree of AChE depression.

Occupational pesticide handlers are at an elevated risk for exposure to these chemicals through skin contact, inhalation, or accidental ingestion. Organophosphate intoxication can be a result of one or more high exposure events or through chronic lower-level exposure.

Both serum and erythrocyte cholinesterase activity are inhibited by these insecticides, which are among the most commonly used pesticides in the United States. The half-life of serum cholinesterase (eg. pseudocholinesterase) is about 8 days, while the half-life of AChE in erythrocytes is between 2 and 3 months. Therefore, erythrocyte AChE is an indicator of chronic and temporally distant exposures to organophosphates.

Reference Range Information
31.2-61.3 U/g of hemoglobin
 
Reference values have not been established for patients less than 18 years of age.
Interpretation
​Activities less than normal are suspect for exposure to certain insecticides.  For occupational high-risk individuals, a pre-exposure "baseline" is recommended.
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​82482
Synonyms/Keywords
​Carbamates, Cholinesterase, Insecticide Poisoning, Organo-Phosphate Poisoning, RBC Acetyl Cholinesterase
Ordering Applications
Ordering Application Description
​Cerner ​Acetylcholinesterase RBC (ACHS)
​COM ​Cholinesterase - RBC (ACHS)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Whole blood EDTA Lavender Top Tube (LTT)​ 4 mL​ 2.5 mL​
Collection Processing

​Specimen must arrive within 72 hours of draw. Date of draw is required.

Send whole blood specimen in original tube.  Do not aliquot. 

Specimen Stability Information
Specimen Type Temperature​Time
​Whole blood Refrigerated (preferred)​​72 hours
Rejection Criteria
Gross hemolysis
Interference

​Make sure the potential offending agent is, indeed, an acetylcholinesterase inhibitor. 

Useful For
​Detecting effects of chronic or remote (months) past exposure to cholinesterase inhibitors (organophosphate insecticide poisoning)
Reference Range Information
31.2-61.3 U/g of hemoglobin
 
Reference values have not been established for patients less than 18 years of age.
Interpretation
​Activities less than normal are suspect for exposure to certain insecticides.  For occupational high-risk individuals, a pre-exposure "baseline" is recommended.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available Methodology/Instrumentation
Mayo Clinic Laboratories
 Wednesday 4 to 8 days​
Spectrophotometric-Thiocholine Production​
Reference Lab
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​82482
For most current information refer to the Marshfield Laboratory online reference manual.