This test gives a quantitative measurement of the amount of ceruloplasmin in the patient’s serum. Measurement of ceruloplasmin aids in the diagnosis of copper (Cu²⁺) metabolism disorders—that is, Wilson disease Cu²⁺ bound to ceruloplasmin constitutes the largest amount of Cu²⁺ in the circulation. In Wilson disease, Cu²⁺ mobilization from the liver is drastically reduced because of the low production of ceruloplasmin.

Test values can vary considerably from patient to patient and may be 50% of normal (pointing to some other primary defect). Patients with Wilson disease are not always extremely low in ceruloplasmin.

• Adults: 18–53 mg/dL or 180–530 mg/L by nephelometry

• Neonates: 2–13 mg/dL or 20–130 mg/L

1. Collect a 7-mL blood serum sample in a red-topped tube. Observe standard precautions.

2. Label the specimen with the patient’s name, date, and test(s) ordered and place in a biohazard bag for transport to the laboratory.

1. Values <14 mg/dL are expected in Wilson disease. Deficient ceruloplasmin, however, is not the primary defect in Wilson disease and therefore can vary considerably from patient to patient.

Pretest Patient Care

1. Explain test purpose and procedure. Measurement of this serum protein aids in diagnosing a copper metabolism disorder known as Wilson disease.

2. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

1. Ceruloplasmin is affected by infections (a late acute-phase reactant) and liver function.

2. Decreased levels are seen before 6 months of age.

3. Birth control pills and pregnancy will increase ceruloplasmin, as well as copper intoxication.