Soluble transferrin receptor in complicated anemia

• HIGHLIGHTS
• Our aim was to understand if sTfR is the best diagnostic tool in complicated anemia.
• To this aim we have critically revised the literature.
• sTfR was more sensitive but the ferritin sensitivity was influenced by cut-offs.
• Other studies are needed to assess the superiority of sTfR to ferritin in these cases.

Determination of serum soluble transferrin receptor (sTfR) has been proposed to identify iron-deficiency anemia (IDA) in patients affected by concurrent inflammatory disease that may spuriously increase ferritin concentration. The aim of this study was to critically review the available literature to assess the diagnostic efficacy of sTfR in complicated anemia. The criteria for study selection were: enrolment of patients with complicated anemia; bone marrow examination used as diagnostic gold standard for IDA; evaluation of sTfR vs. ferritin and binary data presentation. Six published studies met the criteria. However, the small size and wide heterogeneity of the studies did not allow us to conduct a meta-analysis. sTfR was overall more sensitive, even though it was evident that the ferritin sensitivity was influenced by selected cut-offs. Well-designed studies are still needed to define the added value, if any, of sTfR to ferritin for IDA detection in complicated anemia.