Ceruloplazmina

Ceruloplasmin is a glycoprotein produced in the liver. Binds copper ions – it consists of 90% of copper in the serum. Copper is excreted from the body via the bile – also in the form of ceruloplasmin. We perform the examination of ceruloplasmin when there is a suspicion of disturbances in the management of copper ions.

Ceruloplasmin – what is it?

Ceruloplasmin (ferroxidase) is a protein produced in the liver to bind and transport copper ions in the blood. It is an antioxidant and also supports iron binding with transfer due to the oxidation of iron from Fe2 + to Fe3 +. In addition, it has the ability to activate the processes of ascorbic acid, norepinephrine, sulfhydryl compounds and norepinephrine oxidation. The determination of the level of ceruloplasmin is performed along with the level of serum copper concentration and its 24-hour urine copper excretion. Increased levels of this protein indicate the presence of inflammation in the body, which is why ferroxidase is classified as acute phase proteins.

Wilson’s disease and ceruloplasmin

Wilson’s disease is a disease in which there is an increase in the accumulation of copper in the human body. This condition is genetically determined and is associated with a defect in the protein transporting copper into hepatocytes – which leads to impaired ceruloplasmin synthesis. Ultimately, there is an increase in unbound copper in the serum and its excess accumulates in organs such as the liver, brain. This leads to organ damage as a consequence.

Ceruloplasmin – when do we do?

We perform Ceruloplasmin testing in the following cases:

  1. disturbances in the management of copper ions (suspicions),
  2. suspicion of Wilson’s disease,
  3. in people in the 2nd or 3rd decade of life, with cirrhosis or hepatitis of unknown origin, accompanied by: tremors of the upper limbs, salivation and appetite disorders. Speech disorders and problems with movement (balance disorders) also occur in a certain group of patients.

Ceruloplasmin – preparation for the study

  1. Material for the study of ceruloplasmin: serum.
  2. Preparation for the test: on an empty stomach (at least 8 hours).
  3. The course of the ceruloplasmin test: one-time blood sampling from a vein in the arm. In children, a small skin incision is made with a lancet. The collected material is sent further for laboratory analysis.
  4. Time of waiting for the result: 1 day.
  5. Norma: 1,5-3,0 µmol/l (200-400 mg/l).
  6. Notes: Ceruloplasmin is a protein responsible for the transport of copper ions in the serum and the oxidation of polyphenols. Thus, it is the main antioxidant of plasma and plays the role of an oxidase. The concentration of ceruloplasmin increases due to the use of oral contraceptives and during pregnancy. However, a decrease in the concentration of ceruloplasmin occurs in the case of hereditary disorders of copper ion metabolism – in Wilson’s disease.

Ceruloplasmin – normal norms and result analysis

What are the relevant norms of ceruloplasmin?

  1. Adults: 30-58mg / dl.
  2. Children up to 6 years of age: 24-145 mg / dl.

Who may develop elevated levels of ceruloplasmin?

  1. in smokers,
  2. in women taking hormonal contraception,
  3. in pregnant women,
  4. in people suffering from rheumatic diseases,
  5. in people with cancer,
  6. during inflammation and tissue necrosis in the body (it may increase the synthesis of ceruloplasmin in the liver).

What does the decreased level of ceruloplasmin suggest?

  1. Menkes syndrome (this disease is characterized by a golden-brown discoloration around the cornea, which is related to the deposition of copper),
  2. Wilson’s disease (a genetic disease caused by a defect in the protein responsible for transporting copper to the inside of hepatocytes),
  3. lack of diets in the diet.

The lowering of the concentration of ceruloplasmin in the body does not always mean that we are dealing with Wilson’s disease, because the test is not very sensitive. For this reason, the most common measurements are the serum copper concentration and urinary copper excretion and the amount of copper in the liver biopsy. Thanks to the performance of these tests and the analysis of the clinical symptoms, the diagnosis of Wilson’s disease is more likely.

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