Test ID: NEZPP
Zinc Protoporphyrin, Blood
NY State Approved 
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Evaluating iron deficiency
Monitoring treatment and environmental intervention of chronic lead poisoning
Method Name A short description of the method used to perform the test
Hematofluorometry
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Zinc Protoporphyrin
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Container/Tube:
Preferred: Royal, blue-top Monoject trace element blood collection tube, product #8881-307022 (Supply T183), containing EDTA as an anticoagulant
Acceptable: Heparin (<24 hours old)
Specimen Volume: 1 mL
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild reject; Gross reject |
| Lipemia | Mild reject; Gross reject |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Whole blood | Refrigerated | 14 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
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 RBCs.
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 Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
<70 mcmol ZPP/mol heme
Interpretation Provides information to assist in interpretation of the test results
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.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
No significant cautionary statements
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Stanton NV, Gunter EW, Parsons PJ, et al: Empirically determined lead-poisoning screening cutoff for the Protofluor-Z hematofluorometer. Clin Chem 1989;35(10):2104–2107
2. Rosen JF: Preventing Lead Poisoning in Young Children. US Public Health Service, Centers for Disease Control, Atlanta, GA, 1991
3. Occupational Safety and Health Administration: OSHA Lead Standard-Requirements from the General Industry Standards Lead (1910, 1025), from 29 CFR 1910, 1025, A.M. Best Safety and Security-2000. Available from URL: ambest.com/safety/osha/chap10g.html Retrieved March 2000
4. Centers for Disease Control and Prevention. Screening Young Children for Lead Poisoning. Guidance for State and Local Public Health officials. Atlanta, GA: US Dept of Health and Human Services. Public Health Service: November 1997 Available from URL: cdc.gov/nceh/lead/guide/guide97.htm
Method Description Describes how the test is performed and provides a method-specific reference
Zinc protoporphyrin is measured on the Helena ProtoFluor-Z hematofluorometer using a multi-channel front surface photofluorometer. When the sample is exposed to 415 nm light, zinc protoporphyrin (ZPP) is excited and emits light at 595 nm. A second lens/filter system collects, filters and focuses the 595 nm light onto a photomultiplier tube (PMT). The PMT produces a current level in response to the light reaching it, which is proportional to the ZPP/heme ratio. During the 5 second reading, over 1,000 light-level readings are taken and averaged by the micro-computer and a value is displayed in mcmol ZPP/mol heme. (Instruction manual: Helena ProtoFluor-Z 7/2006)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday; 3rd shift
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
84202
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 300009 | Zinc Protoporphyrin, B | 2893-6 |
External
link
PDF
document
Excel
document
Word
document