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Transferrin-derived TIBC, a flagged but normal result
Martin Safran1, James Corines1, Matthew Elkins1
1Department of Pathology & Laboratory Medicine, State University of New York, Upstate Medical University, Syracuse, NY, USA.
Summary
Varying conversion factors for Total Iron Binding Capacity (TIBC) calculations are common in US labs, potentially causing discordant results. However, these differences in TIBC reference intervals appear to have no adverse impact on patient care.
Area of Science:
- Clinical Chemistry
- Laboratory Medicine
- Hematology
Background:
- Total Iron Binding Capacity (TIBC) is a key diagnostic marker for iron disorders.
- TIBC is often calculated from transferrin levels using a conversion factor.
- Variations in conversion factors and their impact on TIBC reference intervals are not well understood.
Purpose of the Study:
- To investigate the commonality and impact of differing conversion factors used in calculating TIBC reference intervals.
- To identify the root cause of discordant results between transferrin and TIBC measurements.
- To assess the clinical significance of these discrepancies on patient care.
Main Methods:
- Analysis of electronic medical records and laboratory procedures.
- Online survey of conversion factor usage across 21 CLIA-certified clinical laboratories in the USA.
- Examination of reference interval calculation methods for TIBC.
Main Results:
- Discordance between transferrin and TIBC results was observed.
- 66% of surveyed laboratories used varying conversion factors for TIBC reference intervals (lower limit: 0.74-1.44; upper limit: 1.07-1.42).
- Observed discordances did not adversely affect patient care quality.
Conclusions:
- The use of diverse conversion factors for TIBC reference intervals is prevalent in US clinical laboratories but often goes unnoticed.
- Discrepancies are more likely to occur near the limits of the reference range.
- These variations in TIBC calculations are unlikely to negatively impact patient management.
