Fractionated faecal porphyrins

Description
Fractionated faecal porphyrins is a test offered by the SAS Porphyria Laboratory in Reference Chemistry at the Synnovis Hub laboratory in Blackfriars. It is used in the investigation of the porphyrias and only performed following a positive total faecal porphyrin screen or other positive porphyrin investigations. Quantitative measurement of porphyrins and their isomers in faeces is carried out using high-performance liquid chromatography (HPLC) followed by fluorescence detection.
Clinical details

Porphyrins are intermediates in the haem biosynthesis pathway. Semi-quantitation of total faecal porphyrins is recommended following a positive blood or urine porphyrin screen, to support the diagnosis and differentiation of porphyria. If total faecal porphyrins are elevated, the sample is subsequently analysed by high-performance liquid chromatography (HPLC) for porphyrin fractionation, which helps identify the characteristic porphyrin pattern and determine the specific type of porphyria. Increased faecal porphyrin concentrations are typically observed in: Hereditary Coproporphyria (HCP), Variegate Porphyria (VP), Porphyria Cutanea Tarda (PCT), and Congenital Erythropoietic Porphyria (CEP). Normal or mildly elevated levels may be seen in: Acute Intermittent Porphyria (AIP), Erythropoietic Protoporphyria (EPP) and X-linked Protoporphyria (XLP). It is important to note that marginal elevations in faecal porphyrins can occur due to non-porphyric causes, such as the bacterial degradation of dietary haem or gastrointestinal bleeding. Reported porphyrin fractions in faeces include: (bullet points) Coproporphyrin I, Coproporphyrin III, Total Coproporphyrin (I + III), Dicarboxylate Porphyrin.

Related condition
Reference range

Total Coproporphyrin (I and III): 0 – 46 nmol/L/g dry weight, Dicarboxylate Porphyrin: 0 – 134 nmol/g dry weight

Units

nmol/g (dry weight)

Synonyms

POLC, HPLC porphyrins, fractionation, porphyrins

Testing site
Synnovis : Reference Services : Blackfriars Hub
Laboratory
Porphyrins
Sample type and volume required

Faeces, plain Universal container. Protect from light.

Special sample instructions

Protect from light

Storage and transport

Specimens can be stored up to one week at fridge temperature and can be sent by first class post. If delays in dispatch, freeze specimen until ready to send. Keep protected from light.

Turnaround time

21 days

Contacts

Porphyrin Laboratory at Blackfriars Hub
Phone: 0208 078 8996
Email: PorphyrinLab@synnovis.co.uk
Porphyrin Laboratory
Floor 1, Synnovis hub
Friars Bridge Court
41-43 Blackfriars Road
London, SE1 8NZ

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