Diagnostic significance of serum soluble transferrin receptors in various anemic diseases: The first multi-institutional joint study in Japan

Akira Matsuda, Masami Besso, Shigehisa Mori, Tsutomu Takeuchi, Tohru Abe, Yoshihito Yawata, Hiraku Mori, Mitsuhiro Omine, Yuichi Nakamura, Shinpei Furusawa, Teiryo Maeda, Susumu Haginosita, Yoshihei Hirasawa, Eriko Kinugasa, Tadao Akizawa, Naohito Kawakami, Atsuo Nagata, Kunitake Hirashima

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Serum soluble transferrin receptor (sTfR) has been reported to be higher in patients with iron deficiency or with elevated erythropoiesis. In the present study, serum sTfR was measured in various anemic diseases and their clinical significance was examined in a multi-institutional joint study. Serum sTfRs in patients with the following anemic diseases were markedly higher than those in normal healthy adults: non-treated iron deficiency anemia (IDA) (9.13 ± 7.04 mg/l, n = 52, p < 0.0001), anemia of chronic disorders (ACD) (3.45 ± 1.38 mg/l, n = 20, p < 0.0001), hemolytic anemia (HA) (5.57 ± 3.26 mg/l, n = 17, p < 0.0001), and myelodysplastic syndrome (MDS) (4.03 ± 2.83 mg/l, n = 20, p < 0.0001). There were significant differences between IDA and ACD (p < 0.0001), between aplastic anemia (AA) (1.58 ± 1.26 mg/l, n = 16) and MDS (p < 0.001), and between AA and MDS with refractory anemia (MDS-RA) (4.16 ± 3.40 mg/l, n = 9) (p < 0.02). In patients with chronic renal failure (CRF), serum sTfR levels and serum sTfR/log serum ferritin ratios (sTfR/F index) were compared in the two classified groups according to Muirhead's criteria, as IDA and non-IDA groups with or without recombinant human erythropoietin (rHuEPO) treatment. Significantly high levels of both serum sTfR (p < 0.0001) and the sTfR/F index (p < 0.0001) were observed in IDA without rHuEPO treatment. Especially in CRF with rHuEPO treatment, the sTfR/F index showed marked elevation in the IDA group (p < 0.0001) compared with serum sTfR (p < 0.001), indicating more diagnostic efficacy of the sTfR/F index for CRF with IDA. In conclusion, the serum sTfR concentration is a useful diagnostic tool for discrimination between IDA and ACD, and between AA and MDS-RA, and for the detection of iron deficiency in CRF patients in the Japanese population.

Original languageEnglish
Pages (from-to)225-238
Number of pages14
Issue number3
Publication statusPublished - 2002
Externally publishedYes


  • Anemia
  • Anemia of chronic disorders
  • Aplastic anemia
  • Chronic renal failure
  • Iron deficiency anemia
  • Myelodysplastic syndrome
  • Soluble transferrin receptor

ASJC Scopus subject areas

  • Hematology


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