CERULOPLASMIN

CLINICAL UTILITY:

Ceruloplasmin (molecular weight 150,000) is a copper-containing alpha-2 globulin synthesized in the liver. Ceruloplasmin transports copper and it's main clinical importance is in the diagnosis of Wilson's disease.

Copper is believed to be transported from the gut to the liver where it is incorporated into ceruloplasmin and then released into the bloodstream. Increased absorption of copper leads to increased synthesis of ceruloplasmin, thereby providing a first-line reaction to potential copper toxicity. In the plasma, circulating ceruloplasmin serves as a stable pool of copper in nontoxic form. Cells are believed to take up ceruloplasmin to obtain the copper essential for the synthesis of such enzymes as monoamine oxidase, diamino oxidase , and ascorbate oxidase, each of which contains one copper atom per molecule.

Ceruloplasmin is increased in malignancy (most notably in Hodgkin's disease), trauma, infection or obstruction of the biliary tract, stress, pregnancy and oral contraceptives.

Decreased levels of ceruloplasmin have been linked to protein malnutrition, severe liver disease and most significantly in Wilson's disease. The increased levels of copper in patients with Wilson's disease are not only deposited in the liver, but also the kidneys, the brain, and the cornea, giving rise to the characteristic Kayser-Fleischer rings.

METHOD DESCRIPTION:

Ceruloplasmin in this assay is measured in a nephelometric method.

REFERENCE RANGE:

22.0 - 66.0 mg/dl

SPECIMEN REQUIREMENTS:

Serum is the specimen of choice, plasma is acceptable; 0.3 mL minimum.