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Acquired pseudocholinesterase deficiency after high-dose cyclophosphamide

Bone Marrow Transplantation volume 24, pages 1367–1368 (1999)Cite this article

Abstract

Succinylcholine, a depolarizing neuromuscular blocking agent used in anesthesia is hydrolyzed in the plasma by the enzyme pseudocholinesterase (PSC). Conditions associated with reduced PSC activity lead to sustained action of succinylcholine and result in prolonged apnea. Cyclophosphamide is an inhibitor of PSC and its suppressive effect may be dose-dependent. We report a case of severe PSC deficiency after high-dose cyclophosphamide at 7 g/m2. The patient received succinylcholine during anesthesia 9 h after chemotherapy and developed prolonged apnea. This case highlights the potential risk of drug-induced PSC deficiency and cautions the use of depolarizing muscular relaxants soon after high-dose cyclophosphamide.

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Authors and Affiliations

  1. Division of Pediatrics, University of Texas MD Anderson Cancer, Houston, TX, USA

    V Koseoglu & KW Chan

  2. Division of Anesthesiology and Critical Care, University of Texas MD Anderson Cancer, Houston, TX, USA

    J Chiang

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  1. V Koseoglu
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  2. J Chiang
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  3. KW Chan
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Koseoglu, V., Chiang, J. & Chan, K. Acquired pseudocholinesterase deficiency after high-dose cyclophosphamide. Bone Marrow Transplant 24, 1367–1368 (1999). https://doi.org/10.1038/sj.bmt.1702097

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  • DOI: https://doi.org/10.1038/sj.bmt.1702097

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