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Test ID: CERS Ceruloplasmin, Serum


Specimen Required


Patient Preparation: Patient should be fasting: 4 hours preferred, nonfasting acceptable

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial.


Useful For

Investigation of patients with possible Wilson disease

Testing Algorithm

For information see Wilson Disease Testing Algorithm.

Special Instructions

Method Name

Nephelometric Assay

Reporting Name

Ceruloplasmin, S

Specimen Type

Serum

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 7 days
  Frozen  30 days

Clinical Information

Ceruloplasmin is a positive acute-phase reactant and a copper-binding protein that accounts for over 95% of serum copper in normal adults. Ceruloplasmin is measured primarily to assist with a diagnosis of Wilson disease. Other indications include Menkes disease, dietary copper insufficiency, and risk of cardiovascular disease.

 

Wilson disease is a rare inherited disorder of copper transport that results in low serum copper and ceruloplasmin and accumulation of copper in various tissues. The pathological accumulation of copper in the liver, brain, cornea, and kidney causes cirrhosis, neuropsychiatric symptoms, Kayser-Fleischer rings, and hematuria/proteinuria, respectively. See Wilson Disease Testing Algorithm for appropriate use of clinical findings, serum biomarkers, genetic tests, and tissue biopsies when working up suspected cases.

 

Menkes disease is an X-linked disorder in which dietary copper is absorbed from the gastrointestinal tract but cannot be transported, so copper is not available to the liver for incorporation into ceruloplasmin.

 

Dietary ceruloplasmin deficiency may be due to inadequate dietary copper intake, long-term parenteral nutrition without copper supplementation, malabsorption, penicillamine therapy, or a combination of these.

Reference Values

Males:

0-8 weeks: 7.4-23.7 mg/dL

9 weeks-5 months: 13.5-32.9 mg/dL

6-11 months: 13.7-38.9 mg/dL

12 months-7 years: 21.7-43.3 mg/dL

8-13 years: 20.5-40.2 mg/dL

14-17 years: 17.0-34.8 mg/dL

≥18 years: 19.0-31.0 mg/dL

 

Females:

0-8 weeks: 7.4-23.7 mg/dL

9 weeks-5 months: 13.5-32.9 mg/dL

6-11 months: 13.7-38.9 mg/dL

12 months-7 years: 21.7-43.3 mg/dL

8-13 years: 20.5-40.2 mg/dL

14-17 years: 20.8-43.2 mg/dL

≥18 years: 20.0-51.0 mg/dL

Interpretation

Low concentrations of ceruloplasmin are consistent with Wilson disease and warrant further investigation according to the recommended algorithm; see Wilson Disease Testing Algorithm.

 

Ceruloplasmin is a positive acute-phase reactant. Increases in serum ceruloplasmin have been reported during pregnancy, in women taking oral contraceptives, in hepatitis, pneumonia, tuberculosis, rheumatoid arthritis, myocardial infarction, various forms of anemia, and many obscure neurological disorders.

Clinical Reference

1. Wilson Tang WH, Wu Y, Hartiala J, et al: Clinical and genetic association of serum ceruloplasmin with cardiovascular risk. Arterioscler Thromb Vasc Biol. 2012 Feb;32(2):516-522

2. Dadu RT, Dodge R, Nambi V, et al: Ceruloplasmin and heart failure in the Atherosclerosis Risk in Communities study. Circ Heart Fail. 2013 Sep 1;6(5):936-943

3. Cox DW, Tumer Z, Roberts EA: Copper transport disorders: Wilson's disease and Menkes disease. Inborn Metabolic Disease. Fernandes J, Sandubray JM, VandenBerghe F, eds. Springer-Verlag; 2000:385-391

4. Sontakke AN, More U: Changes in serum ceruloplasmin levels with commonly used methods of contraception. Indian J Clin Biochem. 2004 Jan:19(1):102-104

5. Schilsky ML: Wilson disease: Diagnosis, treatment, and follow-up. Clin Liver Dis. 2017 Nov;21(4):755-767

6. Hermann W: Classification and differential diagnosis of Wilson's disease. Ann Transl Med. 2019 Apr;7(Suppl 2):S63

Day(s) Performed

Monday through Sunday

Report Available

1 to 7 days

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

82390

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CERS Ceruloplasmin, S 2064-4

 

Result ID Test Result Name Result LOINC Value
CERS Ceruloplasmin, S 2064-4

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Benign Hematology Test Request (T755)

-General Request (T239)

-Gastroenterology and Hepatology Test Request (T728)

-Biochemical Genetics Test Request (T798)

Mayo Clinic Laboratories | Gastroenterology Catalog Additional Information:

mml-gi-liver-genetic