Zinc protoporphyrin, a useful parameter to address hyperferritinemia

Area of Science:

• Hematology
• Biochemistry

Background:

• Zinc protoporphyrin (ZPP) is an indicator of iron-related erythropoiesis issues.
• Iron deficiency leads to increased ZPP levels.
• Hereditary hemochromatosis (HE) is characterized by iron overload.

Purpose of the Study:

• To investigate ZPP levels in hereditary hemochromatosis (HE).
• To determine if ZPP can help clarify hyperferritinemia in HE.
• To differentiate HE from other causes of hyperferritinemia.

Main Methods:

• Measured ZPP concentrations in 20 HE patients and 160 patients with other hyperferritinemic conditions.
• Utilized Aviv front-face hematofluorometer for ZPP measurement.
• Compared ZPP values between HE patients, historical controls, and other hyperferritinemic groups.

Main Results:

• HE patients exhibited significantly lower ZPP levels (median 20 µmol/mol heme) compared to controls.
• ZPP levels remained low in HE patients even after iron reduction therapy (phlebotomy).
• Other hyperferritinemic conditions generally showed higher ZPP levels than HE.

Conclusions:

• ZPP is significantly lower in hereditary hemochromatosis.
• A ZPP level ≤25 µmol/mol heme demonstrated high diagnostic accuracy (87%) for detecting HE in non-transfused hyperferritinemic patients.
• ZPP serves as a valuable biomarker for distinguishing HE from other hyperferritinemic disorders.