Ceruloplasmin

Test Description

Ceruloplasmin is an alpha2-globulin protein that transports copper. It also regulates
iron uptake by transferrin. Testing for ceruloplasmin gives direct information regarding
the amount of copper in the blood serum. Ceruloplasmin levels increase during
times of stress, infection, and pregnancy.
This test is used to aid in the diagnosis of Wilson’s disease, a hereditary syndrome
in which decreased levels of ceruloplasmin are manufactured by the liver.
Without ceruloplasmin to transport it, copper accumulates in the tissues of the
brain, eye, kidney, and liver. One of the hallmarks of this disease is the presence of
copper deposits around the iris of the eye, known as Kayser-Fleischer rings.
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THE EVIDENCE FOR PRACTICE

Serum ceruloplasmin should be routinely measured during the evaluation of unexplained
hepatic, neurologic, or psychiatric abnormalities in children and adults through middle age.
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Normal Values :23–43 mg/dL (230–430 mg/L SI units)

Possible Meanings of Abnormal Values

Increased                                                 Decreased

Cancer Hypocupremia due to                   hyperalimentation
Cirrhosis                                                   Kwashiorkor
Infection                                                   Malabsorption
Inflammation (rheumatoid arthritis)         Menkes’ kinky hair syndrome
Pregnancy                                                 Nephrotic syndrome
Primary sclerosing cholangitis Normal infants (under 6 months)
Stress Sprue
Thyrotoxicosis Wilson disease
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Contributing Factors to Abnormal Values
• Drugs that may increase ceruloplasmin levels: estrogen, methadone, oral contraceptives,
phenytoin.
• Hemolysis of the blood sample will alter test results.
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Interventions/Implications

Pretest

• Explain to the patient the purpose of the test and the need for a blood sample to be drawn.
• No fasting is required before the test.

  Procedure

• A 7-mL blood sample is drawn in a collection tube containing no additives.
• Gloves are worn throughout the procedure.

Posttest
• Apply pressure at venipuncture site. Apply dressing, periodically assessing for continued
  bleeding.
• The sample is labeled and transported to the laboratory.
• Report abnormal findings to the primary care provider.
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Clinical Alerts
• First-degree relatives of any patient newly diagnosed with Wilson disease must be
screened for the disease.
Cervical