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23035 Zinc Protoporphyrin (NEZPP)

Zinc Protoporphyrin (NEZPP)
Test Code: ZPPSO
Synonyms/Keywords
​Ref Lab Code: 300009, Protoporphyrin, Zinc, Zinc Protoporphyrin
Useful For
Evaluating iron deficiency
 
Monitoring treatment and environmental intervention of chronic lead poisoning​
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​ Royal blue-top Monoject trace element blood collection tube, containing EDTA as an anticoagulant​ ​ 1 mL​ 0.1 mL​ ​
Collection Processing Instructions
​See Mayo's Lead/Heavy Metals Reporting Form.
Specimen Stability Information
Specimen Type Temperature Time
​Whole blood ​Refrigerated ​14 days
Rejection Criteria
Hemolysis Mild reject; Gross reject
​Lipemia ​Mild reject; Gross reject
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Medical Laboratories Monday through Friday​ ​1 day
Hematofluorometry​
Reference Lab
Mayo Clinic Laboratories
Test Information
​The porphyrins are intermediaries in the heme synthesis pathway. When iron is not available for heme synthesis (eg, iron deficiency), zinc protoporphyrin (ZPP) accumulates within red blood cells. Lead inhibits several enzymes in the heme synthesis pathway and causes increased levels of RBC ZPP. ZPP is a biological marker of lead toxicity and was previously used, in conjunction with blood lead assays, to screen for lead poisoning in children. However, because of poor sensitivity and specificity, ZPP is no longer recommended for lead screening in children. However, ZPP remains a useful tool for monitoring treatment of individuals with confirmed elevated lead levels.
Reference Range Information
Performing Location Reference Range
​Mayo Medical Laboratories ​<70 mcmol ZPP/mol heme
Interpretation
An elevated zinc protoporphyrin (ZPP) indicates impairment of the heme biosynthetic pathway.
 
In children, a blood lead level of >20 ug/dL and an ZPP level of >70 mcmol ZPP/mol heme are indicative of lead toxicity.(1)
 
Elevated ZPP levels in adults may indicate long-term (chronic) lead exposure or may be indicative of iron deficiency anemia or anemia of chronic disease.​
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​84202 ​ ​ ​ ​
Synonyms/Keywords
​Ref Lab Code: 300009, Protoporphyrin, Zinc, Zinc Protoporphyrin
Ordering Applications
Ordering Application Description
​Centricity Zinc Protoporphyrin, Blood (300009)​
Cerner​ None​
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​ Royal blue-top Monoject trace element blood collection tube, containing EDTA as an anticoagulant​ ​ 1 mL​ 0.1 mL​ ​
Collection Processing
​See Mayo's Lead/Heavy Metals Reporting Form.
Specimen Stability Information
Specimen Type Temperature Time
​Whole blood ​Refrigerated ​14 days
Rejection Criteria
Hemolysis Mild reject; Gross reject
​Lipemia ​Mild reject; Gross reject
Useful For
Evaluating iron deficiency
 
Monitoring treatment and environmental intervention of chronic lead poisoning​
Reference Range Information
Performing Location Reference Range
​Mayo Medical Laboratories ​<70 mcmol ZPP/mol heme
Interpretation
An elevated zinc protoporphyrin (ZPP) indicates impairment of the heme biosynthetic pathway.
 
In children, a blood lead level of >20 ug/dL and an ZPP level of >70 mcmol ZPP/mol heme are indicative of lead toxicity.(1)
 
Elevated ZPP levels in adults may indicate long-term (chronic) lead exposure or may be indicative of iron deficiency anemia or anemia of chronic disease.​
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Medical Laboratories Monday through Friday​ ​1 day
Hematofluorometry​
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​84202 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.