Serum transferrin receptor in diagnosis of iron deficiency

The aim of the present study is to assess the diagnostic value of the serum transferrin receptor in distinguishing IDA (iron deficiency anemia) from ACD (anemia of chronic diseases) and combination of IDA and ACD (COMBI anemia) as compared to conventional laboratory tests of iron metabolism.

Serum iron and serum ferritin are tests most commonly used for the detection of iron deficiency, however their values may be falsely changed. Serum fransferrin receptor (sTfR) has been introduced as a new tool, and its values are not affected by an increase in cytokine production in ACD patients.

In the retrospective study, 39 patients with IDA, 29 patients with ACD and 25 patients with COMBI, were evaluated using iron status tests including sTfR assay. The control group consisted of 33 healthy adults.

Serum iron values in IDA, ACD and COMBI groups were not significantly different. Serum ferritin values distinguished IDA from ACD reliably but the diagnostic usefulness of ferritin measurements in ACD and COMBI patients is limited for their large variation breadth. Serum TfR concentrations were elevated in the vast majority of the IDA and COMBI patients and distinguished them from the ACD group. The distinguishing of IDA from COMBI of the single basis of iron status is still difficult. However, the detection of iron deficiency in COMBI patients is very useful for the initiation of replacement therapy.

We conclude that sTfR measurement is a valuable non-invasive tool for the diagnosis of iron depletion and an attractive supplement to more conventional laboratory tests in the detection of depleted iron stores. (Tab. 2, Fig. 3, Ref. 25.).