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Enzymes and Protein Markers |
1
Divisions of Laboratory Medicine and
2
Hematology, Departments of Pathology and Medicine, Washington University School of Medicine, St. Louis, MO 63110.
a Address correspondence to this author at: Division of Laboratory Medicine, Box 8118, 660 S. Euclid Ave., St. Louis, MO 63110. Fax 314-362-1461; e-mail mscott{at}labmed.wustl.edu.
Soluble transferrin receptor (sTfR) and ferritin concentrations were
measured in a variety of clinical settings to compare the ability of
these two tests to identify iron deficiency. Among 62 anemic patients
who either had a bone marrow aspirate performed or had a documented
response to iron therapy, the diagnostic sensitivity and specificity of
sTfR (at a diagnostic cutoff of >2.8 mg/L) were 92% and 84%,
respectively, with a positive predictive value of 42% in this
population. Ferritin (
12 µg/L) had a sensitivity of 25% and a
specificity of 98%. However, the sensitivity and specificity of
ferritin could be improved to 92% and 98%, respectively, by using a
diagnostic cutoff value of 30 µg/L, resulting in a positive
predictive value of 92%. Ferritin and sTfR were also measured in 267
outpatient samples and 112 medical students. In the outpatient group,
the two tests agreed in 73% of the samples; however, 25% of the
samples had ferritin values >12 µg/L and increased sTfR. Among the
medical students, there was 91% agreement between the two tests, but
7% of the samples had ferritin 12 µg/L and normal sTfR. Together,
these data suggest that measurement of sTfR does not provide sufficient
additional information to ferritin to warrant routine use. However,
sTfR may be useful as an adjunct in the evaluation of anemic patients,
whose ferritin values may be increased as the result of an acute-phase
reaction.
The following articles in journals at HighWire Press have cited this article:
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  J. N. Nanas, C. Matsouka, and M. I. Anastasiou-Nana Reply J. Am. Coll. Cardiol., June 12, 2007; 49(23): 2302 - 2302. [Full Text] [PDF]
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D. L. O'Connor, M. E. Latulippe, C. Campos, C. Merlos, S. Villalpando, and M. F. Picciano Folate Deficiency Does Not Alter the Usefulness of the Serum Transferrin Receptor Concentration as an Index for the Detection of Iron Deficiency in Mexican Women during Early Lactation J. Nutr., January 1, 2005; 135(1): 144 - 149. [Abstract] [Full Text] [PDF]
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E. J. Lee, E.-J. Oh, Y.-J. Park, H. K. Lee, and B. K. Kim Soluble Transferrin Receptor (sTfR), Ferritin, and sTfR/Log Ferritin Index in Anemic Patients with Nonhematologic Malignancy and Chronic Inflammation Clin. Chem., July 1, 2002; 48(7): 1118 - 1121. [Full Text] [PDF]
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A. E. Mast, M. A. Blinder, Q. Lu, S. Flax, and D. J. Dietzen Clinical utility of the reticulocyte hemoglobin content in the diagnosis of iron deficiency Blood, February 15, 2002; 99(4): 1489 - 1491. [Abstract] [Full Text] [PDF]
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 K E Fallon, S K Fallon, and T Boston The acute phase response and exercise: court and field sports Br. J. Sports Med., June 1, 2001; 35(3): 170 - 173. [Abstract] [Full Text] [PDF]
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L. T. Goodnough, B. Skikne, and C. Brugnara Erythropoietin, iron, and erythropoiesis Blood, August 1, 2000; 96(3): 823 - 833. [Abstract] [Full Text] [PDF]
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E. J. Harthoorn-Lasthuizen, P. vant Sant, J. Lindemans, and M. M.A.C. Langenhuijsen Serum Transferrin Receptor and Erythrocyte Zinc Protoporphyrin in Patients with Anemia, Clin. Chem., May 1, 2000; 46(5): 719 - 722. [Full Text] [PDF]
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J. W. Choi, M. W. Im, and S. H. Pai Serum Transferrin Receptor Concentrations during Normal Pregnancy Clin. Chem., May 1, 2000; 46(5): 725 - 727. [Full Text] [PDF]
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P. Suominen, K. Punnonen, A. Rajamaki, R. Majuri, V. Hanninen, and K. Irjala Automated Immunoturbidimetric Method for Measuring Serum Transferrin Receptor Clin. Chem., August 1, 1999; 45(8): 1302 - 1305. [Full Text] [PDF]
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 C. Brugnara, D. Zurakowski, J. DiCanzio, T. Boyd, and O. Platt Reticulocyte Hemoglobin Content to Diagnose Iron Deficiency in Children JAMA, June 16, 1999; 281(23): 2225 - 2230. [Abstract] [Full Text] [PDF]
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B. S. Skikne Circulating Transferrin Receptor Assay—Coming of Age Clin. Chem., January 1, 1998; 44(1): 7 - 9. [Full Text] [PDF]
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