• Seema Nadeem
  • Shahida Shah
  • Touqueer Iqbal
  • Zafar Iqbal
  • Ejaz Hanif


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 beenconsidered 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 transferrinreceptor in serum, is an important new haematological parameter. The ratio of sTfR to log SF is knownas sTfR-SF index. This study was conducted to evaluate sTfR, Ferritin and sTfR-F Index in diagnosingand 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 bonemarrow examination done for various reasons were included in the study. sTfR, SF, and their indexwere measured and compared with bone marrow iron stores. Absence of iron stores denoted IDAwhereas increased macrophage iron with decreased siderocytes and sideroblasts was diagnostic ofACD. Results: Out of 80 anaemic patients, 47 were diagnosed as IDA while 33 were diagnosed asACD. 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%, index89.86%, while SF had accuracy of 79.71%. Conclusion: sTfR-SF index is a better parameter than sTfRor ferritin alone but should only be used when the results of these parameters seem altered or a bonemarrow aspiration is mandatory for diagnosis of ACD. The estimation of sTfR or index may offer asimple 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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