The activity of plasma pseudocholinesterase (PChE) was determined on admission and prior to discharge from the hospital in 200 patients admitted consecutively to a medical ward specialized in liver and infectious diseases. In 24% of patients without liver diseases and without malignant growths the pseudocholinesterase-activity was below normal on admission but increased during the observation period toward normal values. There was a negative correlation between pseudocholinesterase-activity and the intensity of the inflammatory activity as measured by granulocyte count, ESR, body temperature and IgA. This correlation could be established for patients without demonstrable liver pathology as well as for liver diseases. Elevated pseudocholinesterase-levels were observed only in three cases of toxic liver injury (2 heavy drinkers, 1 case of polytoxicomania). In all patients with malignant diseases subnormal values of pseudocholinesterase were observed. Only one patient had normal pseudocholinesterase-activity on admission, but the pseudocholinesterase decreased within a few weeks to subnormal values as the underlying malignant melanoma progressed. The decrease of pseudocholinesterase-activity in malignant diseases was independent of the presence of liver metastases.
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