Ceruloplasmin | Laboratory research

General Information

Ceruloplasmin is a copper-binding alpha-2 globulin. 70% of total serum copper is transported by ceruloplasmin, 7% by a high molecular weight protein (transcuprein), 19% by albumin, and the remaining 2% by various amino acids.

Ceruloplasmin is synthesized in liver cells, in an amount of 6 mg/kg of body weight per day. Copper is incorporated into ceruloplasmin during its synthesis in the liver. Copper atoms give ceruloplasmin a blue color. After copper is incorporated, ceruloplasmin molecules are transported to copper-consuming tissues, where copper is released and protein is broken down. Excretion is carried out through the biliary tract.

In addition to transporting copper, ceruloplasmin also performs other functions:

• Divalent Fe ²⁺Oxidation of iron to trivalent ricin Fe ³⁺ .
• Antioxidant activity, thereby protecting cell membrane lipoproteins from oxidation
• Anti-inflammatory activity, via blocking serum histamine

Low ceruloplasmin concentrations are observed in Wilson's disease (hepatolenticular degeneration). The mechanism of this disease is a violation of the process of copper incorporation into the ceruloplasmin molecule and the accumulation of copper in the liver and other tissues.

The acquired form of ceruloplasmin deficiency is caused by protein-losing pathologies and liver failure.

Because ceruloplasmin is an acute phase reactant, its concentration increases during acute or chronic inflammatory processes.

When is the survey conducted?

• Suspected Wilson's disease in children without viral liver disease
• Neurological disorders of unknown etiology (coordination of movement)
• Hypochromic microcytic anemias that do not respond to iron-containing therapy (due to copper deficiency)
• Neurodegenerative symptoms and connective tissue pathologies in children (suspected Menkes syndrome)

Preparation of the patient: The study is conducted on an empty stomach

Research material – Venous blood

Reference norms

Ceruloplasmin levels depend on age and gender. Concentrations are higher in women than in men.

Interpretation of results

Ceruloplasmin levels in newborns and infants are 50% lower than in adults, so Wilson's disease is not diagnosed in infancy.

Ceruloplasmin levels increase during pregnancy and when taking oral contraceptives.

A normal ceruloplasmin level does not exclude the diagnostics of Wilson's disease. Additional determination of plasma and urinary copper is necessary.

Excessive treatment with zinc preparations may disrupt the process of copper absorption from the intestine, in which case the developed diseases (neutropenia, anemia, leukopenia) are characterized by low levels of ceruloplasmin.

Very rarely, in gammopathies, especially Waldenstrom's macroglobulinemia (IgM), ceruloplasmin levels are inaccurate.