Ceruloplasmin Test

What is the Ceruloplasmin test?

Ceruloplasmin is an important glycoprotein that is manufactured by the liver. It accounts for the transportation of more than 95 percent of copper in the blood plasma. As an enzyme, it also plays an important role in the oxidation of the ferrous iron into ferric iron to facilitate the transportation of iron in the blood and this reaction requires the presence of copper.

Apart from iron metabolism, copper is also required in various bodily functions that include building strong bones, producing energy and making melanin.  It also plays a significant role in energy formation, forming connective tissues and assisting the central nervous system to function properly.

Any imbalance in the copper levels in the blood can result in serious health disorders. The ceruloplasmin carries the copper from the liver to the various body tissues that need it. The ceruloplasmin protein has a complex shape which contains six copper atoms per molecule that help it to use copper for facilitating cellular energy production and preventing oxygen radical formation.

Any mutation in the ceruloplasmin gene that negates the copper unification in the ceruloplasmin structure, upsets the process of iron metabolism.

The ceruloplasmin test is used to measure the amount of glycoprotein in the blood. It is mostly used with the blood copper level tests to diagnose a rare genetic disorder called Wilson disease. This is a condition that prevents the excretion of excess copper from the body. The excess copper overflows from the liver and gradually build-up in the brain, kidneys, bones, corneas and other organs which is dangerous.

Those suffering from the disease are asked not to consume food items rich in copper like liver, shellfish, mushrooms, nuts, chocolate, etc. along with any dietary supplements that include copper. When the tests show low levels of ceruloplasmin and high levels of copper in the urine, Wilson’s disease is a high probability. The progression of the disease may result in conditions like ascites, edema, hypersplenism, and hepatic encephalopathy. Lack of treatment can eventually lead to hepatic insufficiency, liver failure, and death.

Individuals with a family history of Wilson’s disease have higher chances of inheriting an abnormal gene from both parents. In general, the symptoms appear within the age period of 5 and 35 but it can vary. In many cases, abnormal ceruloplasmin levels can result from other liver diseases like hepatitis and cirrhosis.  The test is also used to help identify conditions that are triggering lower than normal copper levels in the blood. Apart from that, the test is used to diagnose the following conditions.

– Malnutrition, a condition where there is a lack of sufficient nutrition in the diet.

– Malabsorption, a condition that makes it hard for your body to absorb and use the nutrients that are consumed.

– Menkes syndrome, a rare, incurable inherited disease.

Why do I need to undergo a Ceruloplasmin test?

In most cases, the test is used to diagnose conditions related to the abnormal levels of copper in the blood. Some of the symptoms related to a copper imbalance in the blood are listed below.

– Trouble speaking, walking or swallowing
– Tremors in various body areas.
– Lack of coordination
– Stiffness in muscles and joint pain
– Changes in behavior patterns.
– Anemia
– Low platelet or white blood cell count
– A slow blood clotting rate.
– High amounts of amino acids, protein, uric acid, and carbohydrates in the urine.
– Development of osteoporosis and arthritis.
– Formation of Kayser-Fleischer rings around the cornea which can be seen through an eye exam.

In addition, the symptoms may also include the following.

– A swollen liver or spleen.
– Yellowing of the skin and eyes or jaundice.
– A build-up of fluid in the legs and belly.
– Extreme physical tiredness.
– Loss of appetite.
– Lots of easy bruising.

The test is ordered periodically for patients with excess or deficient copper levels and to evaluate the effectiveness of the treatment for the disease. In some babies, the test might be needed if they have specific symptoms that occur during infancy and can be related to Menkes syndrome. These include the following.

– Hair that is brittle, sparse, and tangled.
– Feeding difficulties.
– Failure to grow and developmental delays.
– Lack of muscle tone.
– Seizures.

How is a Ceruloplasmin test performed?

The procedure for the test is simple and the entire method can be completed within a few minutes. The process involves the collection of the required volume of blood from a vein, which is usually selected from the elbow region or from the back of the hand.  Since it involves the puncture of a vein, the process is termed as venipuncture. It involves the following steps.

– The healthcare practitioner will first disinfect the collection site with an antiseptic.

– Then an elastic band is wrapped and tightened around the upper arm in order to apply some pressure and make the vein swell with blood. The veins are thus easier to locate and also make the collection process easier.

– The needle is gently inserted into the vein. This step will result in a slight stinging sensation or pain for the patient.

– The required volume of blood is withdrawn and it gets collected into an airtight vial or tube attached to the needle. After the same is collected, the band is removed from the upper arm to release the pressure.

– The needle is then removed, the collection site is covered by a cotton ball and a slight pressure is applied on it to stop any bleeding.

– In the case of infants or young children, veins are difficult to find and in many cases, a sharp tool called a lancet is used to break the skin and collect the required volume of blood.

– In some adult patients, veins may not be distinctly visible, making the collection process difficult. In such cases, multiple punctures can be needed. The collection site might develop bruises or a throbbing sensation may be felt after the collection.

– Any tenderness or bruising in the area is usually cured within a few days. While most patients do not show any side effects, for a few, symptoms like the ones mentioned below can occur.

– Excessive bleeding.
– A sensation of dizziness or light-headedness.
– Fainting as a result of blood loss.
– An infection or a hematoma at the puncture site.

These conditions will need special medical attention at the earliest.

What is the price of a Ceruloplasmin test in India? 

The cost of the test varies between Rs 700 to Rs 2000 in India depending on the location and facilities provided in the testing center.

When will I get the test results?

In general, the turn around time is 1 to 2 days but it may vary depending on the laboratory and other external conditions.

What is the normal range for a Ceruloplasmin test?

The standard levels of ceruloplasmin for all age groups are between 20 and 50 mg/dL (milligrams per decilitre).

What do the results mean?

When the levels are low, it means that the body is unable to get rid of excess copper. This can be the sign of any of the following ailments.

– Wilson disease
– Menkes syndrome
– Liver disease
– Malnutrition
– Problem with absorbing nutrients
– Nephrotic syndrome or a kidney disease

When the levels of ceruloplasmin are higher than normal, it can be a sign of any of the following conditions.

– A serious infection
– Heart disease
– Rheumatoid arthritis
– Leukemia
– Hodgkin lymphoma

The levels can also be higher in case of a pregnancy, estrogen therapy and use of birth control pills. Based on the test results, the doctor can order for further tests which can include the following.

– Blood tests for copper and amino acids.
– Liver function tests.
– Certain genetic tests.
– MRI scan in case of nerve problems and change in behavioral patterns.

Do I need to fast for the Ceruloplasmin test?

No fasting or any other special preparation is needed before the test.

What else do I need to know before I appear for a Ceruloplasmin test?

The following points can be kept in mind for a better understanding of the test and the related results.

– The test is not a diagnostic tool to determine a specific condition and is generally used with copper tests.

Anything that affects the supply of copper for a person or the body’s ability to metabolize copper can change the levels of ceruloplasmin.

A small percentage of people who have Wilson disease will have normal ceruloplasmin levels in the blood.

Since ceruloplasmin plays an important role in iron metabolism, conditions like Alzheimer’s disease, Parkinson’s disease, and early cognitive developmental disorders have been associated with abnormalities in its production levels.

Can pregnant women undergo a Ceruloplasmin test?

Pregnant women can undergo the test without any restrictions.

Is the Ceruloplasmin test possible for new-born babies?

The test is possible for new-born babies as recommended by the doctor.