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Zinc protoporphyrin in anemia of chronic disorders
J Hastka, JJ Lasserre, A Schwarzbeck, M Strauch and R Hehlmann
III. Med. Klinik, University of Heidelberg, Germany.
Hematofluorometric determination of zinc protoporphyrin (ZPP) is a
screening method for the assessment of iron deficiency (ID). Chronic
disorders are frequently accompanied by anemias of unclear origin, most
probably caused by an impairment of iron metabolism. We investigated the
relevance of ZPP for the detection of derangements of iron metabolism in
anemias of chronic disorders (ACD). In 19 patients with ACD caused by
chronic inflammatory non-neoplastic diseases, ZPP was determined and
correlated with ferritin, transferrin saturation, and hemoglobin (Hb).
Marrow sideroblast counts and semiquantitative grading of the marrow
hemosiderin were performed in all patients to exclude ID and to show the
decreased iron bioavailability. In all ACD patients who exhibited the
typical laboratory findings of disturbed iron metabolism, such as
hypoferremia, decreased transferrin saturation, decreased bone marrow
sideroblasts, and increased marrow hemosiderin, strongly elevated ZPP
levels were found (131 +/- 23 mumol/mol heme). ZPP returned to normal after
successful treatment of the underlying disease. This is shown in three
patients with polymyalgia rheumatica. We conclude that the fluorometric
determination of ZPP allows detection and quantification of derangements of
iron metabolism associated with chronic inflammatory disorders. By
recording the derangements quantitatively, ZPP allows monitoring of therapy
of chronic inflammatory diseases.
Volume 81,
Issue 5,
pp. 1200-1204,
03/01/1993
Copyright © 1993 by The American Society of Hematology
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