Adult patient:
Heparin gel tube
Minimum blood volume: 5 mL
Paediatric patient:
Paediatric heparin gel tube
Number of vials: 1
Minimum blood volume: 1.3 mL
Authorisation code required
No
24 Hr available service
No
Method
Immunoassay
Reference interval
0.14 - 0.37 g/L
(Source: from local population study in 2006)
Clinical indication
Suspected Wilson's disease and Menkes’ disease. (Urinary and hepatic copper are more reliable tests for Wilson’s disease.)
Result interpretation
Low levels are found in Wilson's disease but a normal level does not exclude this diagnosis. The molar copper / caeruloplasmin ratio is increased in Wilson’s disease due to increased albumin-bound copper.
Decreased ceruloplasmin levels occur in liver failure, Menkes’ disease (where the copper / ceruloplasmin ratio is decreased) and also in nephrotic syndrome, kwashiorkor, sprue, and scleroderma of the small bowel.
Idiopathic hypoceruloplasminaemia occurs as a non-pathogenic genetic variant but aceruloplasminemia causes massive iron overload.
Increased levels may occur in pregnancy and in patients on estrogen therapy. Levels are increased by estrogens, in an acute phase response and in liver disease and this may mask a deficiency state.
Measurement of uncertainty
Frequency of measurement
Weekly