The human placenta transferrin receptor was purified in the form of transferrin-transferrin receptor complex (Tf-TfR), and a monospecific polyclonal antibody against TfR was developed by a Tf-coupled Sepharose 4B affinity chromatography to remove the anti-Tf components in the antiserum. A sandwich enzyme-linked immunoabsorbent assay (ELISA) was established for measuring serum transferrin receptor (sTfR) by using monoclonal antibody OKT9 and monospecific polyclonal antibody. This method is simple, specific and sensitive and has a good accuracy. The measurement of sTfR showed that the level of normal children was 4.54 +/- 1.08 mg/L. There were increased levels of sTfR in patients with severe iron deficiency anemia and those with hemolytic anemia (13.92 +/- 4.45 mg/L and 9.94 +/- 3.22 mg/L, respectively). In patients with aplastic anemia, the level was decreased (2.06 +/- 0.82 mg/L). These results indicate that the sTfR measurement has a differential significance for diagnoses of various anemia.