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HelpEpic Code LAB848 Soluble Transferrin Receptor (sTfR), Serum
Additional Codes
Mayo Code: STFR
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Evaluation of suspected iron deficiency in patients who may have inflammation, infection, or chronic disease and other conditions in which ferritin concentration does not correlate with iron status, including:
-Cystic fibrosis patients who frequently have inflammation or infections(1-2)
-Evaluating insulin-dependent diabetics who may have iron-deficiency resulting from gastric autoimmunity and atrophic gastritis(3)
Specimen Type
SerumSpecimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged, and the serum aliquoted into a plastic vial within 2 hours of collection.
COLLECTION NOTE: Volumes listed are in serum or plasma, draw approximately 2 1/2 times the requested volume in whole blood.
Specimen Minimum Volume
0.25 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Frozen (preferred) | 90 days | |
| Refrigerated | 7 days | ||
| Ambient | 72 hours |
Reject Due To
| Gross hemolysis | Reject |
Day(s) Performed
Monday through Sunday
Reference Values
1.8-4.6 mg/L
It is reported that African Americans may have slightly higher values.
Clinical Information
Iron uptake into cells is mediated through internalizing iron-transferrin complexes. The iron-transferrin complex binds to transferrin receptors present on the external face of the plasma membrane, and is internalized through endosomes with ultimate release of iron into the cytoplasm. Plasma membrane-bound transferrin receptor is released by proteolytic cleavage of the extracellular domain, resulting in the formation of a truncated soluble transferrin receptor (sTfR) that circulates freely in the blood.
The concentration of sTfR is an indicator of iron status. Iron deficiency causes overexpression of transferrin receptor and sTfR levels, while iron repletion results in decreased sTfR levels. While ferritin measurement is the accepted method for assessment of iron deficiency, ferritin is an acute-phase reactant and elevates in response to processes that do not correlate with iron status, including inflammation, chronic disease, malignancy, and infection. sTfR is not an acute-phase reactant and the interpretation of iron status using sTfR measurement is not affected by these confounding pathologies.
Cautions
The soluble transferrin receptor (sTfR) immunoassay should not be used for the routine clinical evaluation of patients for iron status when ferritin immunoassay (FERR / Ferritin, Serum) would be appropriate, such as in the absence of confounding pathologies (inflammation, infection, chronic disease, or malignancy).
Patients with hemolysis and recent blood loss may have falsely elevated sTfR levels.
sTfR is elevated in patients with thalassemia and sickle cell disease. Caution should be exercised in managing anemia in these individuals based on the sTfR test results.
Interpretation
Soluble transferrin receptor (sTfR) concentrations are inversely related to iron status; sTfR elevates in response to iron deficiency and decreases in response to iron repletion.
Reporting Name
Soluble Transferrin Receptor (sTfR)Method Name
Immunoturbidimetric Assay
Method Description
Latex-bound anti-sTfR antibodies react with the antigen in the sample to form an antigen/antibody complex. Following agglutination, the complex is measured turbidimetrically on a Roche P Modular.(Package insert: The Tina-quant Soluble Transferrin Receptor Immunoturbidimetric assay for the in vitro quantitative determination of soluble transferrin receptor. Roche Corporation, Indianapolis, IN 46250, 2001)
CPT Code Information
84238
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| STFR | Soluble Transferrin Receptor (sTfR) | 30248-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| STFR | Soluble Transferrin Receptor (sTfR) | 30248-9 |
Report Available
Same day/1 to 2 daysTest Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.Clinical Reference
1. Cook JD, Skikne BS, Baynes RD: Serum transferrin receptor. Ann Rev Med 1993;44:63-74
2. Keevil B, Rowlands D, Burton I, Webb AK: Assessment of iron status in cystic fibrosis patients. Ann Clin Biochem 2000;37:662-665
3. De Block CEM, Van Capenhout CM, De Leeuw IH, et al: Soluble transferrin receptor level: a new marker of iron deficiency anemia, a common manifestation of gastric autoimmunity in type 1 diabetes. Diabetes Care 2000;23:
1384-1388
4. Mast AE, Blinder MA, Gronowski AM, et al: Clinical utility of the soluble transferrin receptor and comparison with serum ferritin in several populations. Clin Chem 1998;44:45-51
5. Rees DC, Williams TN, Maitland K, et al: Alpha thalassaemia is associated with increased soluble transferrin receptor levels. Br J Haematol 1998;103:365-369
6. Duits AJ, Roker RA, van Endt T, et al: Erythropoiesis and Serum sVCAM-1 levels in adults with sickle cell disease. Ann Hematol 2003;82:171-174