Screening for chronic iron overload diseases, particularly hereditary hemochromatosis
See Hereditary Hemochromatosis Algorithm in Special Instructions.
Immunoturbidimetric Assay
Iron (Fe)
Iron (Serum Iron and TIBC) Routine
Iron Binding Capacity (Routine)
Latent Iron Binding Capacity
Transferrin Saturation, Serum
Total Iron-Binding Capacity (TIBC)
See Hereditary Hemochromatosis Algorithm in Special Instructions.
Serum
Patient's age and sex are required.
1. Fasting (12 hours)
2. Iron-containing supplements should be avoided for 24 hours prior to draw.
Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Specimen Volume: 1 mL
Collection Instructions:
1. Draw blood before 12 noon (preferred).
2. Serum gel tubes should be centrifuged within 2 hours of collection.
3. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
If not ordering electronically, complete, print, and send a Benign Hematology Test Request Form (T755) with the specimen.
0.5 mL
Gross hemolysis | Reject |
Gross lipemia | OK |
Gross icterus | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 7 days | |
Frozen | 180 days |
Screening for chronic iron overload diseases, particularly hereditary hemochromatosis
See Hereditary Hemochromatosis Algorithm in Special Instructions.
Ingested iron is absorbed primarily from the intestinal tract and is temporarily stored in the mucosal cells as ferritin (Fe[III]). Ferritin provides a soluble protein shell to encapsulate a complex of insoluble ferric hydroxide-ferric phosphate. On demand, iron is released into the blood by mechanisms that are not clearly understood, to be transported as Fe(III)-transferrin.
Transferrin is the primary plasma iron transport protein, which binds iron strongly at physiological pH. Transferrin is generally only 25% to 30% saturated with iron. The additional amount of iron that can be bound is the unsaturated iron-binding capacity (UIBC). The total iron-binding capacity (TIBC) can be indirectly determined using the sum of the serum iron and UIBC. Knowing the molecular weight of the transferrin and that each molecule of transferrin can bind 2 atoms of iron, TIBC and transferrin concentration is interconvertible.
Percent saturation (100 x serum iron/TIBC) is usually normal or decreased in persons who are iron deficient, pregnant, or are taking oral contraceptive medications. Persons with chronic inflammatory processes, hemochromatosis, or malignancies generally display low transferrin.
Serum iron, total iron-binding capacity, and percent saturation are widely used for the diagnosis of iron deficiency. However, serum ferritin is a much more sensitive and reliable test for demonstration of iron deficiency.
IRON
Males: 50-150 mcg/dL
Females: 35-145 mcg/dL
TOTAL BINDING CAPACITY
250-400 mcg/dL
PERCENT SATURATION
14-50%
In hereditary hemochromatosis, serum iron is usually above 150 mcg/dL and percent saturation is above 60%. In advanced iron overload states, the percent saturation often is above 90%.
For more information about hereditary hemochromatosis testing, see Hereditary Hemochromatosis Algorithm in Special Instructions.
Measurement of serum iron, iron-binding capacity, and percent saturation should not be used as a test for iron deficiency.
1. Tietz Textbook of Clinical Chemistry. Edited by CA Burtis, ER Ashwood. Philadelphia, WB Saunders Company. 1999
2. Fairbanks VF, Baldus WP: Iron overload. In Hematology. Fourth edition. Edited by WJ Williams, AJ Erslev, MA Lichtman.
Under acidic conditions, iron is liberated from transferrin. Lipemic samples are clarified by the detergent. Ascorbate reduces the released Fe(3+) ions to Fe(2+) ions which then react with FerroZine to form a colored complex. The color intensity is directly proportional to the iron concentration and can be measured photometrically.(Package insert: Roche Fe reagent.
Anti-transferrin antibodies react with the antigen in the sample to form an antigen/antibody complex. Following agglutination, this is measured turbidimetrically. Addition of polyethylene glycol (PEG) allows the reaction to progress rapidly to the end point and increases sensitivity.(Package insert: Roche TRSF2 reagent.
Calculations:
TIBC = (Transferrin x 1.18)
% Saturation = Iron/TIBC x 100
Monday through Saturday
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.
83540-Iron
83550-Iron-binding capacity
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
FEC | Iron and Total Fe Binding Cap, S | 50190-8 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
IRON | Iron | 2498-4 |
TIBC | Total Iron Binding Capacity | 2500-7 |
SAT | Percent Saturation | 2502-3 |