Caeruloplasmin

At a Glance

Why Get Tested?

Blood caeruloplasmin levels are measured; to help diagnose Wilson disease or conditions associated with copper deficiencies

When To Get Tested?

When you have symptoms that your doctor thinks are suggestive of Wilson disease or copper deficiency, or results from other blood tests suggest Wilson disease or copper deficiency is possible. It can also be tested at intervals when monitoring a copper related disease or its treatment.

Sample Required?

A blood sample taken from a vein in your arm

Test Preparation Needed?

No test preparation is needed

On average it takes 7 working days for the blood test results to come back from the hospital, depending on the exact tests requested. Some specialist test results may take longer, if samples have to be sent to a reference (specialist) laboratory. The X-ray & scan results may take longer. If you are registered to use the online services of your local practice, you may be able to access your results online. Your GP practice will be able to provide specific details.

If the doctor wants to see you about the result(s), you will be offered an appointment. If you are concerned about your test results, you will need to arrange an appointment with your doctor so that all relevant information including age, ethnicity, health history, signs and symptoms, laboratory and other procedures (radiology, endoscopy, etc.), can be considered.

Lab Tests Online-UK is an educational website designed to provide patients and carers with information on laboratory tests used in medical care. We are not a laboratory and are unable to comment on an individual's health and treatment.

Reference ranges are dependent on many factors, including patient age, sex, sample population, and test method, and numeric test results can have different meanings in different laboratories.

For these reasons, you will not find reference ranges for the majority of tests described on this web site. The lab report containing your test results should include the relevant reference range for your test(s). Please consult your doctor or the laboratory that performed the test(s) to obtain the reference range if you do not have the lab report.

For more information on reference ranges, please read Reference Ranges and What They Mean.

What is being tested?

This test measures the amount of caeruloplasmin in the blood, and is often requested alongside other tests, such as copper levels. Caeruloplasmin is a copper-containing enzyme that plays a role in iron metabolism and copper transport around the body. Copper is an essential mineral that is absorbed in the intestines and then carried to the liver, where it is stored or used to make a variety of other enzymes. The liver binds copper to apocaeruloplasmin to produce caeruloplasmin which is then released into the bloodstream. About 95% of the copper in the blood is bound to caeruloplasmin.

The caeruloplasmin blood test is not diagnostic on its own, but it provides information to your doctor as to whether copper deficiency/Wilson disease is the cause of your symptoms. Your health care team may then follow up with further testing and treatment.

Common Questions

How is it used?

Caeruloplasmin is primarily measured with blood and/or urine copper to help diagnose Wilson 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.
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 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 serum copper when your doctor suspects that you have a copper deficiency and periodically if monitoring is recommended.
What does the test result mean?
Low caeruloplasmin is seen in up to 90% of patients with Wilson disease, and would also be expected in cases of copper deficiency.

However, low caeruloplasmin levels can sometimes be seen in patients who do not have Wilson disease or copper deficiency, so this alone cannot diagnose a copper related disease and needs to be interpreted with results of other tests such as urine/blood copper, clinical findings, or liver biopsy results

A normal caeruloplasmin level does not definitively exclude Wilson disease as a small number of patients may have normal caeruloplasmin levels.

Acute liver disease or high levels of oestrogen (e.g. contraceptive pill, hormone therapy or pregnancy) can also transiently increase low caeruloplasmin levels into the normal range.
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 disease or copper deficiency. These circumstances may include:

Caeruloplasmin levels increases when someone has inflammation, severe infection, tissue damage, and some cancers.

Increases are also 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 disease or a problem with your copper metabolism, it is unlikely that you will ever have this test performed.
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.