Transferrin Receptor 

Updated: Feb 12, 2014
  • Author: Cory Wilczynski, MD; Chief Editor: Eric B Staros, MD  more...
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Reference Range

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]

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Interpretation

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:

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Collection and Panels

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]

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Background

Definition

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]

Indications/Applications

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.

Considerations

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
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