Order Code LABPPFWE Protoporphyrins, Fractionation, Washed Erythrocytes
Additional Codes
Mayo Test Code: PPFWE
Reporting Name
Protoporphyrins, Fractionation, RBCUseful For
Preferred test for analysis of erythrocyte protoporphyrin fractions
Preferred test for evaluating patients with possible diagnoses of erythropoietic protoporphyria or X-linked protoporphyria
Establishing a biochemical diagnosis of erythropoietic protoporphyria or X-linked protoporphyria
Testing Algorithm
This test should not be ordered in conjunction with PEWE / Porphyrins Evaluation, Washed Erythrocytes.
The following algorithms are available:
-Porphyria (Acute) Testing Algorithm
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Washed RBCOrdering Guidance
This test is for assessment for protoporphyria, an erythropoietic porphyria. The preferred test for lead toxicity in children is blood lead. For more information see PBDV / Lead, Venous with Demographics, Blood or PBDC / Lead, Capillary, with Demographics, Blood.
The preferred test for the assessment of occupational exposure to lead is PBPFD / Lead Profile Occupational Exposure, Blood. For suspected hepatic porphyria, the preferred screening test is urine porphyrins. For more information, see PQNRU / Porphyrins, Quantitative, Random, Urine.
Necessary Information
1. Volume of packed cells and total volume of specimen (red cells + saline) are required and must be sent with specimen.
2. Include a list of medications the patient is currently taking.
Specimen Required
Patient Preparation: For 24 hours before specimen collection, patient must not consume any alcohol.
Collection Container/Tube:
Preferred: Green top (sodium heparin)
Acceptable: Dark blue top (metal free heparin), green top (lithium heparin), or lavender top (EDTA)
Submission Container/Tube: Plastic vial
Specimen Volume: Entire washed erythrocyte suspension
Collection Instructions:
Collect and process whole blood specimen as follows:
1. Transfer entire specimen to a 12-mL graduated centrifuge tube.
2. Centrifuge specimen at 4° C for 10 minutes at 2000 rpm.
3. Record volume of packed cells and the total volume of the specimen.
4. Discard supernatant plasma.
5. Wash packed erythrocytes 2 times by resuspension of at least an equal amount of cold 0.9% saline, mix, and centrifuge for 5 minutes at 2000 rpm, discarding supernatant after each washing.
6. Resuspend packed cells to the original total volume with 0.9% saline. Invert specimen gently to mix.
7. Transfer washed erythrocytes into a plastic vial and freeze.
Specimen Minimum Volume
Washed and resuspended erythrocytes: 1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Washed RBC | Frozen (preferred) | 14 days |
| Refrigerated | 14 days |
Special Instructions
Reference Values
Free Protoporphyrin: <20 mcg/dL
Zinc-Complexed Protoporphyrin: <60 mcg/dL
Day(s) Performed
Monday through Friday
CPT Code Information
82542
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| PPFWE | Protoporphyrins, Fractionation, RBC | 94490-0 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 31932 | Zinc-Complexed Protoporphyrin | 2895-1 |
| 31933 | Free Protoporphyrin | 94491-8 |
| INTP6 | Interpretation | 59462-2 |
| BG571 | Total cell suspension | 94496-7 |
| BG572 | Packed cell volume | 94497-5 |
Method Description
Extraction followed by fractionation by high-performance liquid chromatography. Zinc protoporphyrin and free protoporphyrin are separately quantitated.(Smith RM, Doran D, Mazur M, Bush B. High-performance liquid chromatographic determination of protoporphyrin and zinc protoporphyrin in blood. J Chromatogr. 1980;181[3-4]:319-327; Gou EE, Balwani M, Bissell DM, et al. Pitfalls in erythrocyte protoporphyrin measurement for diagnosis and monitoring of protoporphyrias. Clin Chem. 2015;61[12]:1453-1456. doi:10.1373/clinchem.2015.245456)
Reject Due To
| Cell suspension not available | Reject |
Method Name
High-Performance Liquid Chromatography (HPLC)
Forms
If not ordering electronically, complete, print, and send a Biochemical Genetics Test Request (T798) with the specimen.