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Transferrin is the iron transport protein in serum. In cases of iron deficiency, the degree of transferrin saturation appears to be an extremely sensitive indicator of functional iron depletion. The ferritin levels are depressed when there is a deficiency of storage iron. In sideropenia, an iron deficiency can be excluded if the serum transferrin concentration is low, as in inflammation or less commonly, in cases of ascorbic acid deficiency. In screening for hereditary hemochromatosis, transferrin saturation provides a better indication of the homozygous genotype than does ferritin. Transferrin saturation in conjunction with ferritin gives a conclusive prediction of the exclusion of iron overloading in patients with chronic liver disease. Ref. value: 200-360 mg/dL. Serum iron, total iron-binding capacity (TIBC), and percent saturation are useful only in screening for chronic iron overload diseases, particularly hereditary hemochromatosis. Although serum iron, TIBC, and percent saturation are widely used for the diagnosis of iron deficiency, serum ferritin is a much more sensitive and reliable means of demonstrating iron deficiency.In hereditary hemochromatosis, serum iron is usually above 150 mcg/dL and percent saturation exceeds 60%..In advanced iron overload states, the percent saturation often exceeds 90%.
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