Dual significance of hepatic cholinesterase as an index of liver involvement and state of protein-calorie malnutrition.

159 cases of different forms of PCM (K.W.O., marasmic K.W.O., marasmus & nutritional oedema together with 20 cases normal healthy controls were selected. Serum, red blood cells and liver cholinesterases were estimated together with serum total protein and serum albumin. Pathological liver examination was done for every case, some cases from each group were followed-up till clinical recovery and the same investigations were done to them. The results indicate that the serum and hepatic pseudo-cholinesterase activity parallels directly the serum albumin (not the total proteins) as well as the pathological changes in the liver. The diminution in enzymatic activities and serum proteins coincides with the severity of the liver affection in the various forms of PCM. Insignificant change in true cholinesterase was demonstrated in all cases studied. Follow-up studies in a number of cases till clinical recovery revealed the return to normal of enzymatic activity and serum albumin is concomitant with restoration of normal pathological liver finding. The significance of changes in serum and liver cholinesterase activities as indices of the extent of liver involvement as well as their diagnostic and prognostic values was discussed.