title: Zinc protoporphyrin and percentage of hypochromic erythrocytes as markers of functional iron deficiency during therapy with erythropoietin in patients with advanced acquired immunodeficiency syndrome.
abstract: BACKGROUND
  We assessed zinc protoporphyrin (ZPP) and the percentage of hypochromic erythrocytes in patients with advanced acquired immunodeficiency syndrome (AIDS) treated with recombinant erythropoietin (rhEPO).
  
  
  METHODS
  Patients received 150 IU rhEPO subcutaneously every second day for 10 days, and 150 IU rhEPO plus 62.5 mg of intravenous iron every second day for an additional 10 days.
  
  
  RESULTS
  Before rhEPO therapy, ZPP was at 64.3 +/- 27.3 micromol/mol heme and the percentage of hypochromic erythrocytes was elevated at 9.7%, indicating mild functional iron deficiency. Ferritin was 1,002 +/- 956 microg/L, with transferrin saturation of 19.1 +/- 9.7%. Under rhEPO alone, ZPP rose to 80.1 +/- 21.6 micromol/mol heme and the percentage of hypochromic red cells rose to 22.9 +/- 4.7%; ferritin fell to 705 +/- 601 microg/L and transferrin saturation fell to 12 +/- 6.3%. When rhEPO was supplemented with iron, ZPP fell to 70.4 +/- 20.5 micromol/mol heme, the percentage of hypochromic red cells fell to 14.7 +/- 3.4%; ferritin was unchanged at 771 +/- 62 microg/L and transferrin saturation rose to 20.5 +/- 5.5%.
  
  
  CONCLUSIONS
  In contrast to ferritin and transferrin saturation, ZPP and the percentage of hypochromic erythrocytes effectively detect the functional iron deficiency under rhEPO therapy in advanced AIDS.
authors.affiliation: Division of Internal Medicine and Institute of Clinical Chemistry and Laboratory Medicine, University of Münster, Germany.
authors.forename: F K
authors.initials: FK
authors.lastname: Matzkies
authors.forename: P
authors.initials: P
authors.lastname: Cullen
authors.forename: L
authors.initials: L
authors.lastname: Schaefer
authors.forename: M
authors.initials: M
authors.lastname: Hartmann
authors.forename: H
authors.initials: H
authors.lastname: Hohage
authors.forename: R M
authors.initials: RM
authors.lastname: Schaefer
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000097:blood* / Q000150:complications*; D000328:Adult; D000747:Anemia, Hypochromic / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D015415:Biomarkers / Q000097:blood; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D008297:Male; D008665:Metalloporphyrins / Q000097:blood*; D008875:Middle Aged; D011524:Protoporphyrins / Q000097:blood*; D011994:Recombinant Proteins; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D008665:Metalloporphyrins; D011524:Protoporphyrins; D011994:Recombinant Proteins; D004921:Erythropoietin; C017803:zinc protoporphyrin; D007501:Iron