Resection of a tongue fibroma in a patient with serum butyrylcholinesterase deficiency

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  • NISHI Hiromi
    Department of Oral and Maxillofacial Surgery, Division of Cervico-Gnathostomatology, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University
  • HIGASHIKAWA Koichiro
    Department of Oral and Maxillofacial Surgery, Division of Cervico-Gnathostomatology, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University
  • ONO Shigehiro
    Department of Oral and Maxillofacial Surgery, Division of Cervico-Gnathostomatology, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University
  • TAKI Masayuki
    Department of Oral and Maxillofacial Surgery, Division of Cervico-Gnathostomatology, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University
  • INOUE Shingo
    Department of Oral and Maxillofacial Surgery, Division of Cervico-Gnathostomatology, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University
  • KAMATA Nobuyuki
    Department of Oral and Maxillofacial Surgery, Division of Cervico-Gnathostomatology, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University

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  • 舌線維腫切除術を行った低コリンエステラーゼ血症の１例
  • ショウレイ ホウコク ゼツ センイ シュ セツジョジュツ オ オコナッタ テイコリンエステラーゼ ケツショウ ノ 1レイ

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Abstract

Human butyrylcholinesterase (BChE) is an enzyme existing in plasma and liver that dissolves various choline-ester substrates. The serum cholinesterase level indicates the activity of BChE in serum. Low BChE activity is seen in patients with functional disorders of the liver, organic phosphorus exposure and hereditary serum BChE deficiency. In patients with low BChE activity, prolonged neuromuscular block is induced by the use of depolarizing muscle relaxants, such as succinylcholine for general anesthesia, or breathing trouble can be caused by the use of ester-form local anesthetics.<BR>We report a case of tongue fibroma in a 54-year-old man who had extremely low serum BChE activity. While monitoring the circulatory system, the tumor was resected with the use of an amino-form local anesthetic. Hypertension was seen before surgical treatment, possibly due to mental stress, and an antihypertensive was used. DNA sequencing analysis of the BChE gene in this patient revealed a homozygous missense mutation at nucleotide 1093, which resulted in GGA → CGA at Gly365Arg in exon 2.

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