Using Soluble Transferrin Receptor (sTfR) and the sTfR/log ferritin index for the diagnosis of iron deficiency anemia in inflammatory diseases

Usual tests done for the diagnosis of iron deficiency anemia are affected by inflammation and do not give an accurate status. Soluble transferrin receptor (sTfR) is a very accurate indicator for iron deficiency and is unaffected by inflammation.

sTfR and ferritin levels can be used to calculate the sTfR/log ferritin index (sTfR Index) , which has more accuracy than sTfR alone .

Iron deficiency anemia (IDA) and anemia due to chronic illness (ACD) (also called anemia of inflammation) are the two most common forms of anemia.

Patients who have Iron deficiency anemia in a setting of chronic disease are difficult to diagnose because traditionally used analytes such as ferritin, serum iron, total iron-binding capacity (TIBC) or transferrin, and transferrin saturation are affected by inflammation.

Ferritin levels indicate iron stores and are reduced if iron deficiency anemia. However when associated with chronic inflammation the levels may actually be increased as ferritin is an acute phase reactant and increases in inflammatory conditions .Similarly the serum iron, TIBC, and transferrin are also altered by the coexistence of iron deficiency and acute and chronic infection or inflammation. These changes make the interpretation difficult in iron-deficient patients who have an accompanying infection or inflammatory disease.

Soluble transferrin receptor (sTfR) to indicates iron deficiency and is not allows by inflammation or presence of chronic disease . The levels are elevated in serum and plasma in cases of iron deficiency.

Calculating the sTfR/log ferritin index (sTfR Index) by estimating ferritin with sTfR provides an estimate of body iron over a wide range of normal and depleted iron.

The sTfR Index is more advantageous stage of the reciprocal relationship between two variables influenced by iron deficiency. sTfR Index improves the ability to accurately classify anemia, particularly in anemia accompanying diseases with active inflammation.

sTFR index helps in the differential diagnosis of anemia in patients with chronic disease .

A combination of sTfR and ferritin more than doubled the detection of Iron deficiency Anemia from 41% (ferritin alone) to 92% (ferritin, sTfR, and sTfR Index).

Related Posts

Why should you do a Hs-CRP?

CRP or the C reactive protein is a protein which is made by the liver in response to inflammation anywhere in the body. Hs-CRP is more sensitive than the CRP and can detect lower levels of this protein in the blood. High Hs-CRP levels indicate a risk of getting coronary heart disease. Also, in people who have had a cardiac event, if the Hs-CRP is high, they have higher chances of having a heart attack. If the Hs-CRP levels are normal, the likelihood of another cardiac event is low. Hs-CRP can also be increased in other inflammatory conditions and does not tell the cause of the inflammations. Hs-CRP has to be interpreted with other investigations and clinical features and lifestyle patterns



Group B Streptococcus (GBS) Group B Streptococcus (GBS) is a very common reason for severe infection in new-born.It is also a cause of meningitis in babies less than…

Dengue Fever is a very serious public health problem faced by the whole world but more so by countries like India and many African. It is a…

KEEPING YOUR BONES STRONG AND HEALTHY As we age our bones become brittle and weak, leading to multiple fractures at the slightest trauma. The bone mass reaches…


New year is already here and this new year  let us focus on healthy eating and healthy lives. The changes in the diet will not only benefit…

Leave a Reply

Your email address will not be published. Required fields are marked *