Examinations
Examinations
Ceruloplasmin is a copper-containing ferroxidase involved in iron metabolism and various oxidation-reduction reactions. Copper is an essential mineral obtained from food, absorbed in the intestine, and transported to the liver, where it is either stored or used for the synthesis of specific enzymes.
In the liver, copper binds to apoceruloplasmin, forming ceruloplasmin, which is then released into the bloodstream. Approximately 95% of the body's copper is bound to ceruloplasmin, making its measurement one of the primary diagnostic tools for Wilson's disease (Wilson-Konovalov disease) and the assessment of copper metabolism. In Wilson’s disease, copper mobilization from the liver is impaired due to low ceruloplasmin production, leading to copper accumulation in the liver, brain, and other organs.
Ceruloplasmin is also classified as an alpha-2 globulin, meaning it is an acute-phase protein that increases during stress, pregnancy, infections, and autoimmune diseases.
- Avoid alcohol for 24 hours before the test.
- Do not eat for at least 2 hours before the test (only still water is allowed).
- Infants should be tested before their next feeding.
- Avoid physical and emotional stress for 30 minutes before the test.
- Diagnosis of Wilson’s disease and congenital disorders related to low ceruloplasmin levels and excessive copper accumulation in the liver, brain, and other organs (performed together with blood and/or urine copper tests).
- Monitoring the progression of Wilson’s disease.
Symptoms Suggesting Ceruloplasmin Abnormalities
- Tremors
- Muscle tone disorders
- Kayser-Fleischer rings (brownish ring around the iris)
- Developmental delays
- Jaundice
- Swallowing difficulties
- Anemia
- Nausea
- Abdominal pain
Causes of Increased Ceruloplasmin Levels
- Autoimmune diseases:
- Systemic lupus erythematosus (SLE)
- Rheumatoid arthritis
- Hemorrhagic vasculitis
- Primary sclerosing cholangitis
- Primary biliary cirrhosis
- Many infectious diseases
- Cancer (malignancies):
- Breast cancer
- Hodgkin’s lymphoma
- Carcinoma
- Osteosarcoma
Other Causes of Increased Ceruloplasmin
- Pregnancy
- Liver cirrhosis
- Diabetes
- Epilepsy
- Hepatitis
- Myocardial infarction
- Cardiovascular diseases
- Hyperthyroidism
Causes of Decreased Ceruloplasmin Levels
- Wilson’s disease (Wilson-Konovalov disease)
- Menkes disease (a genetic disorder affecting copper transport)
- Malabsorption syndrome
- Meningococcemia (severe meningococcal infection)
- Nephrotic syndrome
- Prolonged parenteral (intravenous) nutrition