Blood caeruloplasmin levels are measured; to help diagnose Wilson’s disease or conditions associated with copper deficiencies
Caeruloplasmin
When you have jaundice, tiredness, tummy pain, behavioural changes, tremors, or other symptoms that your doctor thinks may be due to Wilson’s disease or copper deficiency. At intervals when monitoring a copper related disease or its treatment.
A blood sample taken from a vein in your arm
No test preparation is needed
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How is it used?
Caeruloplasmin is primarily measured with blood and/or urine copper tests to help diagnose Wilson’s disease, a rare inherited disease associated with low levels of caeruloplasmin and excess storage of copper in the liver, brain, and other organs. Rarely, it may be used to help diagnose a disorder of copper deficiency.
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When is it requested?
It is used along with copper measurements when someone has signs and symptoms that the doctor suspects may be due to Wilson’s disease such as:
- anaemia
- nausea
- tummy pain
- jaundice
- tiredness
- behavioural changes
- tremors
- difficulty walking and/or swallowing
- dystonia
Rarely, caeruloplasmin may also be requested with copper tests when your doctor suspects that you have a copper deficiency and periodically if monitoring is recommended.
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What does the test result mean?
Low caeruloplasmin levels alone cannot diagnose a copper related disease and need to be done with measurements of copper levels.
Test results may include:
- If caeruloplasmin and blood copper concentrations are decreased and urine copper levels are increased, the patient may have Wilson’s disease.
- About 5% of the patients with Wilson’s disease who have neurological symptoms will have normal caeruloplasmin levels as will up to 40% of those with liver disease, especially if they have recently become ill.
- If caeruloplasmin and urine and/or blood copper concentrations are low, then the patient may have a copper deficiency.
- Anything that interferes with the supply of copper or with the body’s ability to metabolise copper has the potential to affect blood caeruloplasmin and copper concentrations.
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Is there anything else I should know?
Caeruloplasmin may be increased in a variety of circumstances which need to be considered when using it to diagnose or monitor Wilson’s disease or copper deficiency. These circumstances may include:
- Caeruloplasmin increases due to it being elevated when someone has inflammation, severe infection, tissue damage, and some cancers.
- Increases seen during pregnancy and with the use of oestrogen, oral contraceptives, and medications such as carbamazepine, phenobarbital, and valproic acid.
Caeruloplasmin is not a routine test. Unless your doctor suspects that you have Wilson’s disease or a problem with your copper metabolism, it is unlikely that you will ever have this test performed.
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Do I need to have a liver biopsy?
If Wilson’s disease is strongly suspected, a liver biopsy may be performed to look for the copper content in the liver.