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22643 Protoporphyrins, Fractionation, Erythrocytes (PPFE)

Protoporphyrins, Fractionation, Erythrocytes (PPFE)
Test Code: MISC
Synonyms/Keywords
EPP (Erythropoietic Protoporphyria), Erythropoietic Protoporphyria, Free Protoporphyrin, Zinc Protoporphyrin
Useful For
​Establishing a biochemical diagnosis of erythropoietic protoporphyria
 
Differential diagnosis of chronic intoxication from exposure to a variety of causes including heavy metals and chemicals
 
Differential diagnosis in some cases of iron-deficiency anemia
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​Whole blood Sodium-heparin Green Top Tube (GTT)​ Dark Blue Top Tube (metal free heparin) (BTT) or Lithium-heparin Green Top Tube (GTT)​ Full tube​ 3 mL​ ​
Collection Processing Instructions
​All porphyrin tests on whole blood can be performed on 1 draw tube.
 
Specimen must arrive within 72 hours of draw. If specimen cannot arrive within 72 hours, order PPFWE/31891 Protoporphyrins, Fractionation, Washed Erythrocytes.
 
1. Patient should abstain from alcohol for 24 hours.
2. Immediately place specimen on wet ice.
 
Additional Information: Include a list of medications the patient is currently taking.
Forms: Please document on the request form or electronic order that a copy is on file. An Informed Consent for Genetic Testing is available in Special Instructions.
Specimen Stability Information
Specimen Type Temperature Time
​Whole blood Refrigerated​ 7 days​
Rejection Criteria
Gross hemolysis
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​
 Monday through Friday​
2 days (not reported on Saturday or Sunday)​
High-Performance Liquid Chromatography (HPLC) with Fluorescence Detection
Includes separate quantitation of zinc protoporphyrins and free protoporphyrins.​
Reference Lab
Mayo Clinic Laboratories
Test Information
​Whenever iron deficiency disorders or lead poisoning are suspected the Zinc Protoporphyrin (ZPP) test gives the needed information. The FEP test (based on solvent extraction of acidified whole blood with fluorescence measurement) is no longer available. For diagnosis of Protopophyria, the preferred test is 'Protoporphyrins, Fractionation, Erythrocytes' which will provide individual measurement of zinc protoporphyrins and free protoporphyrins (increased in Protoporphyria) by HPLC. Specify as a MISC (write-in) test. For other porphyrin disorders, 'Porphyrines, Fractionation, Erythrocytes' is available. This test fractionates uro-, copro-, hepta-, and penta- porphyrins in addition to total proto-porphyrins. Consult clinical PhD or a clinical pathologist for additional information.
Reference Range Information
Free Protoporphyrin: <20 ug/dL packed cells
Zinc-Complexed Protoporphyrin: <60 ug/dL packed cells.
Interpretation
​Values of zinc-complexed protoporphyrin >60 mcg/dL suggest iron deficiency anemia or may indicate chronic intoxication by heavy metals or organic chemicals.
 
A predominance of noncomplexed (free) protoporphyrin indicates a diagnosis of erythropoietic protoporphyria.
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​82542 ​ ​ ​ ​
Synonyms/Keywords
EPP (Erythropoietic Protoporphyria), Erythropoietic Protoporphyria, Free Protoporphyrin, Zinc Protoporphyrin
Ordering Applications
Ordering Application Description
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​Whole blood Sodium-heparin Green Top Tube (GTT)​ Dark Blue Top Tube (metal free heparin) (BTT) or Lithium-heparin Green Top Tube (GTT)​ Full tube​ 3 mL​ ​
Collection Processing
​All porphyrin tests on whole blood can be performed on 1 draw tube.
 
Specimen must arrive within 72 hours of draw. If specimen cannot arrive within 72 hours, order PPFWE/31891 Protoporphyrins, Fractionation, Washed Erythrocytes.
 
1. Patient should abstain from alcohol for 24 hours.
2. Immediately place specimen on wet ice.
 
Additional Information: Include a list of medications the patient is currently taking.
Forms: Please document on the request form or electronic order that a copy is on file. An Informed Consent for Genetic Testing is available in Special Instructions.
Specimen Stability Information
Specimen Type Temperature Time
​Whole blood Refrigerated​ 7 days​
Rejection Criteria
Gross hemolysis
Useful For
​Establishing a biochemical diagnosis of erythropoietic protoporphyria
 
Differential diagnosis of chronic intoxication from exposure to a variety of causes including heavy metals and chemicals
 
Differential diagnosis in some cases of iron-deficiency anemia
Reference Range Information
Free Protoporphyrin: <20 ug/dL packed cells
Zinc-Complexed Protoporphyrin: <60 ug/dL packed cells.
Interpretation
​Values of zinc-complexed protoporphyrin >60 mcg/dL suggest iron deficiency anemia or may indicate chronic intoxication by heavy metals or organic chemicals.
 
A predominance of noncomplexed (free) protoporphyrin indicates a diagnosis of erythropoietic protoporphyria.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​
 Monday through Friday​
2 days (not reported on Saturday or Sunday)​
High-Performance Liquid Chromatography (HPLC) with Fluorescence Detection
Includes separate quantitation of zinc protoporphyrins and free protoporphyrins.​
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​82542 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.