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Test Code ACERB Acetylcholinesterase, Erythrocytes

Reporting Name

Acetylcholinesterase, RBC

Useful For

Detecting effects of chronic or remote (months) past exposure to cholinesterase inhibitors (organophosphate insecticide poisoning)

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Whole Blood EDTA

Ordering Guidance

For testing succinylcholine sensitivity to anesthesia, order PCHE1 / Pseudocholinesterase, Total, Serum.

Shipping Instructions

Specimen must arrive within 72 hours of collection.

Necessary Information

Date of collection is required.

Specimen Required

Container/Tube: Lavender top (EDTA)

Specimen Volume: 4 mL

Collection Information: Send whole blood specimen in original tube. Do not aliquot.

Specimen Minimum Volume

2.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole Blood EDTA Refrigerated 72 hours

Reference Values

31.2-61.3 U/g of hemoglobin


Reference values have not been established for patients younger than 18 years of age.

Day(s) Performed


Test Classification

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information


LOINC Code Information

Test ID Test Order Name Order LOINC Value
ACHS Acetylcholinesterase, RBC 49230-6


Result ID Test Result Name Result LOINC Value
ACHSR Acetylcholinesterase, RBC 49230-6

Clinical Reference

1. Brahmi N, Mokline A, Kouraichi N, et al: Prognostic value of human erythrocyte acetylcholinesterase in acute organophosphate poisoning. Am J Emerg Med. Nov 2006;24(7):822-827. doi: 10.1016/j.ajem.2006.05.009

2. Strelitz J, Engel LS, Keifer MC: Blood acetylcholinesterase and butyrylcholinesterase as biomarkers of cholinesterase depression among pesticide handlers. Occup Environ Med. 2014;71(12):842-847. doi: 10.1136/oemed-2014-102315

3. Mason HJ: The recovery of plasma cholinesterase and erythrocyte acetylcholinesterase activity in workers after over-exposure to dichlorvos. Occup Med (Lond). 2000;50(5):343-347. doi: 10.1093/occmed/50.5.343

4. Assis CR, Linhares AG, Cabrera MP, et al: Erythrocyte acetylcholinesterase as a biomarker of pesticide exposure: new and forgotten insights. Environ Sci Pollut Res. 2018;25:18364-18376. doi: 10.1007/s11356-018-2303-9

5. Robinson DG, Trites DG, Banister EW: Physiological effects of work stress and pesticide exposure in tree planting by British Columbia silviculture workers. Ergonomics. 1993 Aug;36:951-961. doi: 10.1080/00140139308967959

6. Fuortes LJ, Ayebo AD, Kross BC: Cholinesterase-inhibiting insecticide toxicity. Am Fam Phys. 1993 May;47:1613-1620

Method Description

Acetylcholinesterase activity is determined by automated photometric method and hemoglobin is measured by spectrophotometric analysis of lysates from washed packed erythrocytes.(Package insert: Cholinesterase, Roche Diagnostics; V10.0, 02/2017)

Report Available

4 to 8 days

Reject Due To

Gross hemolysis Reject
Gross lipemia OK

Method Name

Spectrophotometric-Thiocholine Production

Secondary ID