SERUM TRANSFERRIN RECEPTOR, SERUM FERRITIN AND SERUM TRANSFERRIN RECEPTOR-FERRITIN INDEX IN ADULTS WITH IRON DEFICIENCY ANAEMIA
Abstract
Background: Serum Ferritin (SF) and iron both show acute phase responses to inflammation, so ironmay fall and ferritin rise independent of the marrow iron store. Bone marrow iron store has been
considered the gold standard, but is invasive, painful and expensive and not suitable for everyone.
Serum transferrin receptor (sTfR) which is the concentration of the soluble fragment of transferrin
receptor in serum, is an important new haematological parameter. The ratio of sTfR to log SF is known
as sTfR-SF index. This study was conducted to evaluate sTfR, Ferritin and sTfR-F Index in diagnosing
and differentiating iron deficiency anaemia (IDA) from anaemia of chronic disease (ACD). Methods:
One hundred and sixteen (116) adult subjects (80 anaemic and 36 controls) who already had their bone
marrow examination done for various reasons were included in the study. sTfR, SF, and their index
were measured and compared with bone marrow iron stores. Absence of iron stores denoted IDA
whereas increased macrophage iron with decreased siderocytes and sideroblasts was diagnostic of
ACD. Results: Out of 80 anaemic patients, 47 were diagnosed as IDA while 33 were diagnosed as
ACD. In case of IDA the diagnostic accuracy of index was 91.57%, sTfR had accuracy of 85.54%
while SF had accuracy of 75.90%. In case of ACD, the diagnostic accuracy of sTfR was 91.30%, index
89.86%, while SF had accuracy of 79.71%. Conclusion: sTfR-SF index is a better parameter than sTfR
or ferritin alone but should only be used when the results of these parameters seem altered or a bone
marrow aspiration is mandatory for diagnosis of ACD. The estimation of sTfR or index may offer a
simple non invasive method that may enable more accurate assessments of iron status in such patients.
Keywords: Serum Transferrin Receptor, Index, Iron deficiency anaemia
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