II. Indications
- Low-cost clinic-based Iron Deficiency screening
- Lead Poisoning screening
III. Physiology
- Protoporphyrin converted to heme by ferrocheletase
- Lead inhibits ferrocheletase
- Protoporphyrin accumulates (ferrocheletase absent)
-
Iron Deficiency results in impaired heme synthesis
- Protoporphyrin accumulates
IV. Technique
- Hematofluorimeter measures Protoporphyrin
V. Efficacy
-
Iron Deficiency Anemia
- Identifies cases of Iron Deficiency prior to Anemia
- Non-specific test (see causes for increase below)
- Misses some cases of Iron Deficiency Anemia
- Perform concurrently with Hemoglobin
- Similar to Transferrin Saturation
- Marks similar timing in Iron Deficiency
-
Lead Poisoning
- Correlated with blood lead level
- See normal values below
VI. Interpretation
- Normal range: 16 - 65 ug/dl (adults)
- Overt Iron Deficiency Anemia: Protoporphyrin >100
- Lead levels correlated with Protoporphyrin
- Protoporphyrin 79: Blood lead level 29
- Protoporphyrin 147: Blood lead level 49
- Protoporphyrin 255: Blood lead level 79
VII. Increased
- Iron Deficiency Anemia
- Lead Poisoning
- Sideroblastic Anemia
- Chronic disease
- Hemolytic Anemia
- Erythropoietic protoporphyria
VIII. References
- Bakerman (1984) Interpretive Lab Data, p. 449
- Kazal (2002) Am Fam Physician 66(7):1217-27 [PubMed]
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| Definition (NCI) | A tetrapyrrole containing 4 methyl, 2 propionic and 2 vinyl side chains that is a metabolic precursor for hemes, cytochrome c and chlorophyll. Protoporphyrin IX is produced by oxidation of the methylene bridge of protoporphyrinogen by the enzyme protoporphyrinogen oxidase. |
| Definition (MSH) | Porphyrins with four methyl, two vinyl, and two propionic acid side chains attached to the pyrrole rings. Protoporphyrin IX occurs in hemoglobin, myoglobin, and most of the cytochromes. |
| Concepts | Biologically Active Substance (T123) , Organic Chemical (T109) |
| MSH | D011524 |
| SnomedCT | 51866008 |
| LNC | LP15839-1, MTHU004691 |
| English | Protoporphyrins, 3,7,12,17-Tetramethyl-8,13-divinyl-2,18-porphinedipropionic Acid, Protoporphyrins [Chemical/Ingredient], protoporphyrins, protoporphyrin, 3,3'-(3,7,12,17-Tetramethyl-8,13-divinylporphine-2,18-diyl)di(propionic acid), 7,12-diethenyl-3,8,13,17-tetramethylporphyrin-2,18-dipropanoic acid, PROTOPORPHYRIN, 2,18-Porphinedipropionic acid, 3,8,13,17-tetramethyl-7,12-divinyl- (8CI), PpIX, 3,7,12,17-tetramethyl-8,13-divinylporphyrin-2,18-dipropanoic acid, Protoporpyrin IX, Protoporphyrin IX, Ooporphyrin, 21H,23H-Porphine-2,18-dipropanoic acid, 7,12-diethenyl-3,8,13,17-tetramethyl-, 3,3'-(3,7,12,17-tetramethyl-8,13-divinyl-21H,23H-porphine-2,18-diyl)-bis-propionic acid, Protoporphyrin, Protoporphyrin (substance) |
| Swedish | Protoporfyriner |
| Czech | protoporfyriny |
| Finnish | Protoporfyriinit |
| Russian | PROTOPORFIRINY, ПРОТОПОРФИРИНЫ |
| French | Ooporphyrines, Protoporphyrines |
| Polish | Protoporfiryny |
| Spanish | protoporfirina (sustancia), protoporfirina, Protoporfirinas |
| German | Protoporphyrine |
| Italian | Protoporfirine |
| Portuguese | Protoporfirinas |
Ontology: Protoporphyrin.free (C0807523)
| Concepts | Clinical Attribute (T201) |
| LNC | LP21411-1, MTHU005178 |
| English | Protoporphyrin.free |
