This test is used to measure how much of a copper-containing protein is in your blood. This test is used to diagnose problems related to copper. These include Wilson disease. Wilson disease is a rare 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% of the copper found in blood. Copper is vital to many processes in your body. These include building strong bones and making melanin. 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 disease, copper is not put in ceruloplasmin. The 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 your brain, corneas, kidneys, liver, bones, and small glands near the thyroid. If not treated, the liver and brain damage from copper poisoning in Wilson disease is fatal.
If you have Wilson disease, you shouldn't eat foods high in copper. These include liver, shellfish, mushrooms, nuts, or chocolate. You should also not take dietary supplements that have copper. You may also want to have your drinking water tested for copper levels.
You may need this test if you have a family history of Wilson disease. You have to inherit an abnormal 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 nerve problems and liver-related problems that look a lot like symptoms of hepatitis.
For example, copper toxicity in the central nervous system from Wilson disease can cause:
Trouble speaking or swallowing
Lack of coordination
Changes in behavior
Copper toxicity in the liver from Wilson disease can cause:
Swollen liver or spleen
Yellowing of the skin and eyes (jaundice)
Buildup of fluid in the legs and belly
Lots of bruising
Other symptoms of Wilson disease include:
Low platelet or white blood cell count
Slow blood clotting
High amounts of amino acids, protein, uric acid, and carbohydrates in the urine
Osteoporosis and arthritis
You may also have Kayser-Fleischer rings. These are brown rings around the corneas in your eyes. These rings are seen only through an eye exam and are a clear sign of Wilson disease. The rings happen in 95% of people with Wilson disease who have nerve symptoms. They happen in 65% of people with liver symptoms.
You may also have tests for copper levels in your blood, urine, or liver tissue.
Your healthcare provider may also look for:
Kayser-Fleischer rings around your corneas
Low copper in your blood serum
A high level of copper in a 24-hour urine sample. This means more than 40 mcg per day.
Higher levels of amino acids in your urine
Hemolytic anemia, or low red cell count
Your provider may also order:
Liver function tests. This includes liver biopsy to look for damage, disease, and copper amounts.
MRI scan. You may need this if you have nerve problems or behavior changes.
Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results may not mean you have a problem. Ask your healthcare provider what your test results mean for you.
The normal range for a ceruloplasmin serum test is 20 to 35 milligrams per deciliter (mg/dL). If you have Wilson disease, your ceruloplasmin level will probably be below 10 mg/dL.
Low ceruloplasmin might also mean Menkes disease. This is a genetic disorder that makes it hard for your body to absorb copper. Low ceruloplasmin might also mean you have:
Nephrotic syndrome, or kidney problems
Advanced liver disease
Problem with absorbing nutrients
Your ceruloplasmin level can be higher than normal because of pregnancy, estrogen therapy, and birth control pills. Diseases such as leukemia, Hodgkin lymphoma, primary biliary cirrhosis, and rheumatoid arthritis can also cause a higher ceruloplasmin level.
If you have Wilson 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. Your ceruloplasmin levels can also be normal even with Wilson disease if you also have acute hepatitis.
The test is done with a blood sample. A needle is used to draw blood from a vein in your arm or hand.
Having a blood test with a needle carries some risks. These include bleeding, infection, bruising, and feeling lightheaded. When the needle pricks your arm or hand, you may feel a slight sting or pain. Afterward, the site may be sore.
Pregnancy, estrogen therapy, and birth control pills can raise ceruloplasmin levels. Inflammation from infection, injury, or trauma can also cause an increase.
You don't need to prepare for this test. Be sure your healthcare provider 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.