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Zinc protoporphyrin, a useful parameter to address hyperferritinemia.
Ann Hematol. 2007 May; 86(5):363-8.AH

Abstract

Zinc protoporphyrin (ZPP) is produced instead of heme as soon as iron support to erythropoiesis becomes insufficient. In iron deficiency the intra-erythrocytic ZPP concentration is increased. The aim of this study was to investigate whether ZPP is influenced by increased iron levels in hereditary hemochromatosis (HE) and is useful in the clarification of hyperferritinemia. Twenty HE patients and 160 patients with hyperferritinemic caused by anemia of chronic disorders, liver diseases, transfusional iron overload and hematologic or solid malignancies were enrolled. ZPP was measured using the Aviv front-face hematofluorometer (normal <or= 40 micromol/mol heme). In HE, ZPP was significantly lower (median, 20 micromol/mol heme; p = 0.0005) compared to our historical control group. At diagnosis, 15 (75%) HE patients had ZPP values <or=25 micromol/mol heme. After phlebotomy, ZPP remained unchanged (median, 23 micromol/mol heme), although the initially high ferritin concentration decreased to normal. ZPP values in the other hyperferritinemic groups were significantly higher compared to HE and control groups. In contrast to HE, ZPP values <or=25 micromol/mol heme were only observed in 11% of cases with non-transfusional hyperferritinemia. The diagnostic accuracy of a ZPP <or=25 micromol/mol heme to detect HE in non-transfused hyperferritinemic patients was 87%, with a sensitivity of 75% and a specificity of 89%. Showing significantly lower values in HE, ZPP seems to be a useful parameter in distinguishing HE from other hyperferritinemic disorders as those conditions are generally accompanied by an increased ZPP.

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Authors+Show Affiliations

Metzgeroth G
III. Medizinische Universitätsklinik Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany.
Schultheis B
No affiliation info available
Dorn-Beineke A
No affiliation info available
Hehlmann R
No affiliation info available
Hastka J
No affiliation info available

MeSH

AdultAgedAged, 80 and overAnemiaDiagnosis, DifferentialErythrocytesFemaleFerritinsHemochromatosisHumansMaleMiddle AgedProtoporphyrins

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

17333188

Citation

Metzgeroth, Georgia, et al. "Zinc Protoporphyrin, a Useful Parameter to Address Hyperferritinemia." Annals of Hematology, vol. 86, no. 5, 2007, pp. 363-8.
Metzgeroth G, Schultheis B, Dorn-Beineke A, et al. Zinc protoporphyrin, a useful parameter to address hyperferritinemia. Ann Hematol. 2007;86(5):363-8.
Metzgeroth, G., Schultheis, B., Dorn-Beineke, A., Hehlmann, R., & Hastka, J. (2007). Zinc protoporphyrin, a useful parameter to address hyperferritinemia. Annals of Hematology, 86(5), 363-8.
Metzgeroth G, et al. Zinc Protoporphyrin, a Useful Parameter to Address Hyperferritinemia. Ann Hematol. 2007;86(5):363-8. PubMed PMID: 17333188.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Zinc protoporphyrin, a useful parameter to address hyperferritinemia. AU - Metzgeroth,Georgia, AU - Schultheis,Beate, AU - Dorn-Beineke,Alexandra, AU - Hehlmann,Rüdiger, AU - Hastka,Jan, Y1 - 2007/02/28/ PY - 2006/12/21/received PY - 2007/02/05/accepted PY - 2007/3/3/pubmed PY - 2007/7/13/medline PY - 2007/3/3/entrez SP - 363 EP - 8 JF - Annals of hematology JO - Ann Hematol VL - 86 IS - 5 N2 - Zinc protoporphyrin (ZPP) is produced instead of heme as soon as iron support to erythropoiesis becomes insufficient. In iron deficiency the intra-erythrocytic ZPP concentration is increased. The aim of this study was to investigate whether ZPP is influenced by increased iron levels in hereditary hemochromatosis (HE) and is useful in the clarification of hyperferritinemia. Twenty HE patients and 160 patients with hyperferritinemic caused by anemia of chronic disorders, liver diseases, transfusional iron overload and hematologic or solid malignancies were enrolled. ZPP was measured using the Aviv front-face hematofluorometer (normal <or= 40 micromol/mol heme). In HE, ZPP was significantly lower (median, 20 micromol/mol heme; p = 0.0005) compared to our historical control group. At diagnosis, 15 (75%) HE patients had ZPP values <or=25 micromol/mol heme. After phlebotomy, ZPP remained unchanged (median, 23 micromol/mol heme), although the initially high ferritin concentration decreased to normal. ZPP values in the other hyperferritinemic groups were significantly higher compared to HE and control groups. In contrast to HE, ZPP values <or=25 micromol/mol heme were only observed in 11% of cases with non-transfusional hyperferritinemia. The diagnostic accuracy of a ZPP <or=25 micromol/mol heme to detect HE in non-transfused hyperferritinemic patients was 87%, with a sensitivity of 75% and a specificity of 89%. Showing significantly lower values in HE, ZPP seems to be a useful parameter in distinguishing HE from other hyperferritinemic disorders as those conditions are generally accompanied by an increased ZPP. SN - 0939-5555 UR - https://www.unboundmedicine.com/medline/citation/17333188/Zinc_protoporphyrin_a_useful_parameter_to_address_hyperferritinemia_ L2 - https://dx.doi.org/10.1007/s00277-007-0271-0 DB - PRIME DP - Unbound Medicine ER -