Porphyrins - blood testProtoporphyrin levels; Porphyrins -- total; Coproporphyrin levels; PROTO test
Porphyrins help form many important substances in the body. One of these is hemoglobin, the protein in red blood cells that carries oxygen in the blood.
Porphyrins can be measured in the blood or the urine. This article discusses the blood test.
How the Test is Performed
A blood sample is needed.
The sample is then placed in ice and taken immediately to the laboratory. Three porphyrins can normally be measured in small amounts in human blood. They are:
- Protoporphyrin (PROTO)
Protoporphyrin is normally found in the highest amount. More tests are needed to show the levels of specific porphyrins.
How to Prepare for the Test
You should not eat for 12 to 14 hours before this test. You may drink water right before the test. Your test results may be affected if you do not follow these instructions.
How the Test will Feel
When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or slight bruising. This soon goes away.
Why the Test is Performed
This test is used to diagnose porphyrias. This is a group of rare disorders often passed down through family members.
It may also be used along with other tests to diagnose lead poisoning and certain nervous system and skin disorders.
This test specifically measures total porphyrin levels. But, reference values (a range of values seen in a group of healthy people) for the individual components are also included:
- Total porphyrin levels: 16 to 60 mcg/dL
- Coproporphyrin level: < 2 mcg/dL
- Protoporphyrin level: 16 to 60 mcg/dL
- Uroporphyrin level: < 2 mcg/dL
Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.
What Abnormal Results Mean
Increased levels of coproporphyrins may be a sign of:
An increased protoporphyrin level may be a sign of:
- Anemia of chronic disease
- Congenital erythropoietic protoporphyria
- Increased erythropoiesis
- Iron deficiency anemia
- Lead poisoning
- Sideroblastic anemia
- Variegate porphyria
An increased uroporphyrin level may be a sign of:
- Congenital erythropoietic porphyria
- Porphyria cutanea tarda
Veins and arteries vary in size so taking a blood sample may be harder in some people than others.
Other slight risks of having blood drawn may include:
- Excessive bleeding
- Fainting or feeling lightheaded
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
Fuller SJ, Wiley JS. Heme biosynthesis and its disorders: porphyrias and sideroblastic anemias. In: Hoffman R, Benz EJ Jr, Silberstein LE, Heslop HE, Weitz JI, Anastasi, JI, eds. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 36.
Mathyr SC, Schexneider KI, Hutchison RE. Hematopoiesis. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 31.
Review Date: 1/27/2015
Reviewed By: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.