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P260. Diagnostic accuracy of zinc protoporphyrin in iron deficiency anaemia in IBD patients

M. Wiesenthal1, D. Jakobsen1, F. Hartmann2, A. Dignass3, J. Stein1, 1Krankenhaus Sachsenhausen, Crohn Colitis Center, Frankfurt, Germany, 2Marien Krankenhaus, Frankfurt, Germany, 3Apaglesion Markus Krankenhaus, Frankfurt, Germany


In the absence of a feasible, non-invasive gold standard, iron deficiency anaemia (IDA) is best measured by the use of multiple indicators. However, the choice of an appropriate single iron biomarker to replace the multiple-criteria model for screening for IDA at the population level continues to be debated. Zinc protoporphyrin (ZPP) has been shown to be a sensitive and specific screening marker for functional iron deficiency.


This study evaluated for the first time the diagnostic value of ZPP in the diagnosis of IDA and differential diagnosis of IDA and anaemia of chronic disease. The study included 22 non-anaemic individuals as controls, 106 inflammatory bowel disease (IBD) patients (Ulcerative Colitis 52; Crohns Disease 54) with IDA divided into non-inflammatory and inflammatory subgroups. Blood count, transferrin saturation, ferritin, C-reactive protein, and zinc protoporphyrin (ZPP) were determined by routine assays.


Receiver operator characteristic curve analysis showed a very high discriminating power for ZPP in the recognition of iron deficiency, which was not affected by acute phase reaction.


This indicates that ZPP is a sensitive marker of body iron status with an additional value over conventional tests for the detection of iron deficiency in IBD patients due to its reliability even under inflammatory conditions.