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Ceruloplasmin (Blood)

Does this test have other names?


What is this test?

This is a blood test used to measure the amount of a copper-containing protein in the blood. This test is used to identify disorders related to copper, such as Wilson's disease. Wilson's disease is an inherited disease that can't be cured.

Ceruloplasmin is a protein made in your liver. Ceruloplasmin stores and carries the mineral copper around your body. Ceruloplasmin carries 65 to 90 percent of the copper found in blood. Copper is vital to many bodily processes, such as bone mineralization and melanin formation, but having too much copper in your body can be toxic.

Your liver normally takes copper from your bloodstream and puts it into ceruloplasmin proteins. The ceruloplasmin is then released into blood plasma. Ceruloplasmin carries copper around your body to the tissues that need it.

In Wilson's disease, a rare recessive genetic disorder, copper is not packaged in ceruloplasmin. Wilson's disease also keeps your liver from sending extra copper to be eliminated in your bowel movements. Instead, copper builds up in your liver until it overflows into the bloodstream. From there, copper builds up in the brain, cornea, kidneys, liver, bones, and small glands near the thyroid. If not treated, the liver and brain damage from copper poisoning in Wilson's disease is fatal.

If you have Wilson's disease, you shouldn't eat foods high in copper, such as liver and shellfish, or take dietary supplements containing copper. You may also want to have your drinking water tested for copper 

Why do I need this test?

You may need this test if you have a family history of Wilson's disease. You have to inherit a gene from both parents in order to have the disease, so it's possible to have this condition even without a known family history. Symptoms usually begin between ages 5 and 35, but they can appear earlier or later in life.

You may also have this test if you have neurological problems and liver-related problems that look a lot like symptoms of hepatitis.

For example, copper toxicity in the central nervous system from Wilson's disease can cause:

  • Trouble speaking or swallowing

  • Tremors

  • Lack of coordination

  • Stiff muscles

  • Changes in behavior 

Copper toxicity in the liver from Wilson's disease can cause:

  • Swollen liver or spleen

  • Jaundice, or yellowing of the skin and eyes

  • Buildup of fluid in the legs and abdomen (belly)

  • Extreme tiredness

  • Excessive bruising 

Other symptoms of Wilson's disease include:

  • Anemia

  • Low white blood cell count

  • Slow blood clotting

  • High concentrations of amino acids, protein, uric acid, and carbohydrates in the urine

  • Osteoporosis and arthritis

You may also have Kayser-Fleischer rings, or brown rings around the corneas in your eyes. These rings are seen only through an eye exam and are a clear sign of Wilson's disease. The rings occur in 95 percent of people with Wilson's disease who have neurological symptoms and in 65 percent of people with liver symptoms.   

What other tests might I have along with this test?

You may also have tests for copper levels in your blood, urine, or liver tissue. 

Your doctor may also look for:

  • Kayser-Fleischer rings in your eyes

  • Low copper in your blood serum

  • A high level of copper in a 24-hour urine sample, or greater than 200 mg in 24 hours

  • Higher levels of amino acids in your urine

  • Hemolytic anemia, or low red cell count  

What do my test results mean?

Many things may affect your lab test results. These include the method each lab uses to do the test. Even if your test results are different from the normal value, you may not have a problem. To learn what the results mean for you, talk with your health care provider.

The normal range for a ceruloplasmin serum test is 20 to 35 milligrams per deciliter (mg/dL). If you have Wilson's disease, your ceruloplasmin level will probably be below 10 mg/dL.

Low ceruloplasmin might also mean Menkes' syndrome, a genetic disorder that interferes with copper absorption; nephrotic syndrome, or kidney problems; advanced liver disease; or a malabsorption problem.

Your ceruloplasmin level can be higher than normal because of pregnancy, estrogen supplements, and oral contraceptives. Diseases such as leukemia, Hodgkin lymphoma, primary biliary cirrhosis, and rheumatoid arthritis can also cause an elevated ceruloplasmin level.

If you have Wilson's disease, the copper level in your blood is usually lower than normal, but it can be higher than normal if you also have acute liver failure. 

How is this test done?

The test requires a blood sample, which is drawn through a needle from a vein in your arm.

Does this test pose any risks?

Taking a blood sample with a needle carries risks that include bleeding, infection, bruising, or feeling dizzy. When the needle pricks your arm, you may feel a slight stinging sensation or pain. Afterward, the site may be slightly sore.

What might affect my test results?

Pregnancy, estrogen supplements, and oral contraceptives can raise ceruloplasmin levels. Inflammation from infection, injury, or trauma can also cause an increase. 

How do I get ready for this test?

You don't need to prepare for this test. Be sure your doctor knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illicit drugs you may use.