Does this test have other names?
What is this test?
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, such as Wilson disease.
Wilson disease is a rare inherited disease. It causes too much copper in your blood.
Ceruloplasmin is a protein made in your liver. It 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 due to copper poisoning from
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.
Why do I need this test?
You may need this test if you have a family history of Wilson disease. You have to
inherit an abnormal gene from both parents 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
Copper toxicity in the liver from Wilson disease can cause:
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 98% of people with Wilson disease who have nerve
symptoms. They happen in about 50% of people with liver symptoms.
What other tests might I have along with this test?
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 micrograms
(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 a liver biopsy to look for damage, disease, and
MRI scan. You may need this if you have nerve problems or behavior changes.
What do my test results mean?
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
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
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
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.
How is this test done?
The test is done with a blood sample. A needle is used to draw blood from a vein in
your arm or hand.
Does this test pose any risks?
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.
What might affect my test results?
Pregnancy, estrogen therapy, and birth control pills can raise ceruloplasmin levels.
Inflammation from infection, injury, or trauma can also cause an increase.
How do I get ready for this test?
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 illegal drugs you may use.