The Indian Journal of Pediatrics

, Volume 77, Issue 2, pp 179–183 | Cite as

Evaluation of serum transferrin receptor and sTfR ferritin indices in diagnosing and differentiating iron deficiency anemia from anemia of chronic disease

  • Shilpa Jain
  • Shashi Narayan
  • Jagdish Chandra
  • Sunita SharmaEmail author
  • Sonal Jain
  • Priya Malhan
Original Article



The present study was conducted to assess the utility of serum transferrin receptor (sTfR) and sTfR ferritin indices to differentiate ACD from IDA and also to diagnose coexisting IDA and ACD.


The study group comprised of 30 IDA patients, 30 cases of ACD and 30 age and sex matched controls. Complete hemogram with peripheral smear examination, markers of ACD, iron profile including serum ferritin and serum transferrin receptor levels were done in all patients and controls. Serum TfR and ferritin indices were calculated.


sTfR levels were significantly higher in the IDA group compared to ACD group (p<0.001). ACD group was further subdivided into two groups on the basis of sTfR levels (B1<3 μg/ml and B2 ≥ μg/ml), suggesting coexisting IDA in group B2. sTfR/log ferritin index was > 1.5 in all cases of IDA and ACD with coexisting IDA while all pure ACD cases and control subjects had sTfR/log ferritin index < 1.5. All case in IDA group had log sTfR/serum ferritin index > 2.55 and all patients with ACD with or without associated iron deficiency had log sTfR/serum ferritin ratio < 2.55.


The sTfR levels along with the above mentioned indices can be very useful in differentiating pure IDA, ACD and ACD with coexisting iron deficiency, thus providing a noninvasive alternative to bone marrow iron.

Key words

Anemia Iron deficiency Anemia of chronic disease Transferrin Receptor 


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Copyright information

© Dr. K C Chaudhuri Foundation 2010

Authors and Affiliations

  • Shilpa Jain
    • 1
  • Shashi Narayan
    • 1
  • Jagdish Chandra
    • 2
  • Sunita Sharma
    • 1
    • 3
    Email author
  • Sonal Jain
    • 1
  • Priya Malhan
    • 1
  1. 1.Department of PathologyLady Hardinge Medical College and associated Kalawati Saran Children’s HospitalNew DelhiIndia
  2. 2.Department of PediatricsLady Hardinge Medical College and associated Kalawati Saran Children’s HospitalNew DelhiIndia
  3. 3.NoidaIndia

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