Test of the Month
Serum transferrin receptor
Version of Record online: 28 AUG 2008
Copyright © 2008 Wiley-Liss, Inc.
American Journal of Hematology
Volume 83, Issue 11, pages 872–875, November 2008
How to Cite
Skikne, B. S. (2008), Serum transferrin receptor. Am. J. Hematol., 83: 872–875. doi: 10.1002/ajh.21279
- Issue online: 24 OCT 2008
- Version of Record online: 28 AUG 2008
- Accepted manuscript online: 28 AUG 2008 12:00AM EST
- Manuscript Accepted: 20 AUG 2008
- Manuscript Revised: 19 AUG 2008
- Manuscript Received: 23 MAY 2008
Transferrin receptors (TfRs) are the conventional pathway by which cells acquire iron for physiological requirements. Under iron-deficient conditions there is an increased concentration of surface TfR, especially on bone marrow erythroid precursors, as a mechanism to sequester needed iron. TfRs are also present in the circulation, and the circulating serum TfR (sTfR) level reflects total body TfR concentration. Under normal conditions erythroid precursors are the main source of sTfR. Disorders of the bone marrow with reduced erythroid precursors are associated with low sTfR levels. The sTfR concentration begins to rise early in iron deficiency with the onset of iron-deficient erythropoiesis, and continues to rise as iron-deficient erythropoiesis progressively worsens, prior to the development of anemia. The sTfR level does not increase in anemia of chronic inflammation, but is increased when anemia of chronic inflammation is combined with iron deficiency. The sTfR level is also increased in patients with expanded erythropoiesis, including hemolytic anemias, myelodysplastic syndromes, and use of erythropoietic stimulating agents. The ratio of sTfR/ferritin can be used to quantify the entire spectrum of iron status from positive iron stores through negative iron balance, and is particularly useful in evaluating iron status in population studies. The sTfR/log ferritin ratio is valuable for distinguishing anemia of chronic inflammation from iron deficiency anemia, whether the latter occurs alone or in combination with anemia of chronic inflammation. Am. J. Hematol., 2008. © 2008 Wiley-Liss, Inc.