Free erythrocyte protoporphyrin levels are useful as a screen for exposure to which metal?

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Enhance your knowledge with the Ciulla Clinical Chemistry Test. Study with interactive quizzes, featuring flashcards and multiple-choice questions. Each question offers hints and explanations for better understanding. Prepare effectively and excel in your exam!

Multiple Choice

Free erythrocyte protoporphyrin levels are useful as a screen for exposure to which metal?

Explanation:
Elevated free erythrocyte protoporphyrin occurs when lead disrupts heme synthesis. Lead inhibits ferrochelatase and ALA dehydratase, so iron cannot be inserted into protoporphyrin IX to form heme. As a result protoporphyrin accumulates in red blood cells, and some is detected as zinc protoporphyrin when zinc substitutes for iron. This rise can accompany lead exposure even before anemia develops, making FEP a useful screening test for lead poisoning. Keep in mind that iron deficiency can also raise FEP, so a high FEP suggests a heme synthesis disturbance and should be followed by a direct measurement of blood lead to confirm exposure.

Elevated free erythrocyte protoporphyrin occurs when lead disrupts heme synthesis. Lead inhibits ferrochelatase and ALA dehydratase, so iron cannot be inserted into protoporphyrin IX to form heme. As a result protoporphyrin accumulates in red blood cells, and some is detected as zinc protoporphyrin when zinc substitutes for iron. This rise can accompany lead exposure even before anemia develops, making FEP a useful screening test for lead poisoning. Keep in mind that iron deficiency can also raise FEP, so a high FEP suggests a heme synthesis disturbance and should be followed by a direct measurement of blood lead to confirm exposure.

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