ISSN 2997-1036
International Journal of Hematology | Vol. 5, No. 8, August 2014 | pp. 57–64
DOI: 10.46882/2014/IJH/000056
Original Article
Title: Evaluation of zinc protoporphyrin levels as an adjunctive indicator for iron deficiency screening in prospective blood donors
Names of Authors: E. F. Chinedu¹, G. H. Haruna², I. J. Balogun³
Authors’ Affiliations: ¹Department of Haematology, University of Nigeria Teaching Hospital, Enugu, Nigeria; ²Department of Blood Transfusion, Lagos State University Teaching Hospital, Ikeja, Nigeria; ³Department of Chemical Pathology, University of Ilorin, Ilorin, Nigeria
Abstract: Screening blood donors solely via copper sulfate or hemoglobin hematocrit values can miss early, pre-anemic iron deficiency. This study evaluated the diagnostic performance of hematofluorometer-derived zinc protoporphyrin (ZPP) levels as a rapid screening tool for identifying subclinical iron deficiency in 250 prospective blood donors. Full blood counts and zinc protoporphyrin ratios were verified against gold-standard serum ferritin parameters. Subclinical iron deficiency, defined by a serum ferritin below 20 ng/ml despite a qualifying screening hemoglobin level (≥ 12.5 g/dl), was detected in 18.4% (46 of 250) of donors. The mean zinc protoporphyrin level was significantly higher in iron-deficient donors (68.4 ± 12.4 μmol/mol heme) compared to iron-replete individuals (32.2 ± 6.5 μmol/mol heme, P < 0.001). Receiver operating characteristic analysis established a zinc protoporphyrin threshold above 45.0 μmol/mol heme as optimal for predicting depleted iron stores, yielding a sensitivity of 84.8% and a specificity of 81.4%. Incorporating zinc protoporphyrin fluorometry into donor assessment protocols provides a fast and inexpensive diagnostic asset that prevents the induction of severe anemia in frequent blood donors.
Keywords: Blood donors, iron deficiency, zinc protoporphyrin, ferritin, pre-transfusion screening
Manuscript Timeline: Received: May 02, 2014; Revised: June 15, 2014; Accepted: July 05, 2014; Published: August 14, 2014