Biochemistry Test

Ceruloplasmin

Dr. Simi Paknikar
Medically Reviewed by Dr. Simi Paknikar, MD
Last Updated on Mar 27, 2014
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Test : Ceruloplasmin

Indications : liver and eye degenerations

Physiology : Ceruloplasmin is a feroxidase enzyme found in the blood of humans. It carries eight atoms of copper and plays a very important role in iron metabolism. The gene responsible for encoding this protein is the CP gene.

The liver takes the copper circulating in the blood and binds it with ceruloplasmin synthesized in the liver. This complex is then released into the plasma to be taken to all the tissues that need it. Ceruloplasmin carries 70% of all the copper found in the plasma. In those with liver-related diseases, the levels of ceruloplasmin drop due to impaired synthesis by the liver.

Normal Range : 0.2-0.55 absorbance units/0.1ml serum

Interpretation : Normal range of ceruloplasmin: 20-60 mg/dL (The exact range varies with each testing laboratory).

Low ceruloplasmin may not have much diagnostic significance unless it is carried out along with copper tests. If the levels of ceruloplasmin are lower than normal, it may indicate:

• Chronic liver disease
• Intestinal malabsorption
• Nephrotic syndrome
• Menkes’ syndrome (rare)
• Wilson copper storage disease (rare)
• Malnutrition

If the levels are higher than normal, it may indicate:

• Acute Infection
• Chronic infection
• Lymphoma
• Leukemia
• Rheumatoid arthritis
• Pregnancy
• Use of birth control pills

When is the test ordered?

Ceruloplasmin tests are ordered if the doctor suspects problems related to copper metabolism or storage. One such disease is the Wilson disease, an inherited and incurable disease. In Wilsondisease, the copper is not properly bound to ceruloplasmin, and the excess of copper reaches the tissues, resulting in toxicity.

The doctor might order the test in patients with symptoms of copper toxicity such as tremors, lack of co-ordination, trouble speaking or moving, stiff muscles, or changes in behavior –all indicative of Wilson’s disease. Anemia, fatigue, abdominal pain and jaundice are other reasons for ordering the test.

The ceruloplasmin test is carried out on a blood sample drawn intravenously.

More Information

Ceruloplasmin is not a routine test and is only carried out if your doctor suspects the Wilson disease. If ceruloplasmin and copper tests indicate Wilson disease, then a liver biopsy may be carried out to assess the copper content in the liver and examine the extent of liver damage.

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