Transferrin Receptor 

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Transferrin receptors, which are blood proteins, may be elevated in persons with iron deficiency. Transferrin receptor testing is used to measure the level of soluble transferrin receptors, thereby aiding in the evaluation of iron deficiency and in the diagnosis of iron-deficiency anemia.

The reference range of transferrin receptor varies by sex in adults, as follows:

Men: 2.2-5 mg/L

Women: 1.9-4.4 mg/L

Reference intervals of transferrin receptors have not been established for pregnant females, children, or recent or frequent blood donors. [1]

Transferrin receptor levels within the reference range indicate normal physiology.

Elevated levels are seen in iron-deficiency anemia.

Decreased transferrin receptor levels are seen in the following:

Iron overload

Protein malnutrition

Atransferrinemia (genetic absence of transferrin receptor)

Collection: Serum separator tube or plasma separator tube; green (sodium or lithium heparin), lavender (EDTA), or pink (K2 EDTA) tubes are also acceptable

Specimen preparation: Transfer 1 mL (minimum, 0.3 mL) of serum or plasma to a tube

Storage/transport temperature: Refrigerated

Unacceptable conditions: Contaminated, severely hemolyzed, icteric, or lipemic specimens

Stability after separation from cells (collection to initiation of testing): ambient, 72 hours; refrigerated, 1 week; frozen, 1 month (avoid repeated freeze/thaw cycles) [1]

Transferrin receptors, which are blood proteins, may be elevated in persons with iron deficiency. Transferrin receptor testing is used to measure the level soluble transferrin receptors, thereby aiding in the evaluation of iron deficiency and in the diagnosis of iron-deficiency anemia.

Transferrin is an iron-binding glycoprotein found in the plasma. Its main function is to control the level of free iron. [2] Unlike ferritin, the transferrin receptor level is not affected by infection or inflammation and is therefore useful in distinguishing iron deficiency anemia from anemia of chronic disease. [3]

Transferrin receptor testing is used in the diagnosis of anemia and in deciding adequate treatment. Along with other tests in an anemia panel (iron, ferritin, reticulocyte count, lactate dehydrogenase [LDH], vitamin B-12, folate), the type of anemia can be diagnosed based on the transferrin receptor levels.

Transferrin receptor testing is particularly useful in the evaluation of microcytic anemia (with mean corpuscular volume [MCV] < 75) to distinguish iron-deficiency anemia from anemia of chronic disease from anemia of chronic inflammation.

Table 1. Anemia Tests (Open Table in a new window)

Test

level in Iron Deficiency Anemia

level in Anemia of Chronic Disease

level in Mixed Iron Deficiency Anemia and Anemia of Chronic Disease

Ferritin

Low

High

Normal or high

Total iron-binding capacity

High

Low

Normal or high

Iron

Low

Low

Low

Transferrin receptor

High

Normal

High

Transferrin Receptor: ARUP Lab Tests. ARUP Laboratories: National Reference Laboratories. Available at http://www.aruplab.com. Accessed: 9/15/12.

Crichton RR, Charloteaux-Wauters M. “Iron transport and storage”. Eur. J. Biochem. 1987. 164(3):485–506.

Weiner, M. A., & Cairo, M. S. Anemia Secondary to Iron deficiency. Pediatric hematology/oncology secrets. Philadelphia: Hanley & Belfus; 2002. 23-25.

Test

level in Iron Deficiency Anemia

level in Anemia of Chronic Disease

level in Mixed Iron Deficiency Anemia and Anemia of Chronic Disease

Ferritin

Low

High

Normal or high

Total iron-binding capacity

High

Low

Normal or high

Iron

Low

Low

Low

Transferrin receptor

High

Normal

High

Cory Wilczynski, MD Fellow, Department of Endocrinology, Loyola Medical Center

Disclosure: Nothing to disclose.

Eric B Staros, MD Associate Professor of Pathology, St Louis University School of Medicine; Director of Clinical Laboratories, Director of Cytopathology, Department of Pathology, St Louis University Hospital

Eric B Staros, MD is a member of the following medical societies: American Medical Association, American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology

Disclosure: Nothing to disclose.

Transferrin Receptor 

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