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HelpTest Code CERS Ceruloplasmin, Serum
Specimen Required
Patient Preparation: Patient should be fasting: 4 hours preferred, nonfasting acceptable
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial.
Secondary ID
614504Useful For
Investigation of patients with possible Wilson disease
Testing Algorithm
For information see Wilson Disease Testing Algorithm.
Special Instructions
Method Name
Nephelometric Assay
Reporting Name
Ceruloplasmin, SSpecimen Type
SerumSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 7 days | |
| Frozen | 30 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Clinical Information
Ceruloplasmin is a positive acute-phase reactant and a copper-binding protein that accounts for over 95% of serum copper in normal adults. Ceruloplasmin is measured primarily to assist with a diagnosis of Wilson disease. Other indications include Menkes disease, dietary copper insufficiency, and risk of cardiovascular disease.
Wilson disease is a rare inherited disorder of copper transport that results in low serum copper and ceruloplasmin and accumulation of copper in various tissues. The pathological accumulation of copper in the liver, brain, cornea, and kidney causes cirrhosis, neuropsychiatric symptoms, Kayser-Fleischer rings, and hematuria/proteinuria, respectively. See Wilson Disease Testing Algorithm for appropriate use of clinical findings, serum biomarkers, genetic tests, and tissue biopsies when working up suspected cases.
Menkes disease is an X-linked disorder in which dietary copper is absorbed from the gastrointestinal tract but cannot be transported, so copper is not available to the liver for incorporation into ceruloplasmin.
Dietary ceruloplasmin deficiency may be due to inadequate dietary copper intake, long-term parenteral nutrition without copper supplementation, malabsorption, penicillamine therapy, or a combination of these.
Reference Values
Males:
0-8 weeks: 7.4-23.7 mg/dL
9 weeks-5 months: 13.5-32.9 mg/dL
6-11 months: 13.7-38.9 mg/dL
12 months-7 years: 21.7-43.3 mg/dL
8-13 years: 20.5-40.2 mg/dL
14-17 years: 17.0-34.8 mg/dL
≥18 years: 19.0-31.0 mg/dL
Females:
0-8 weeks: 7.4-23.7 mg/dL
9 weeks-5 months: 13.5-32.9 mg/dL
6-11 months: 13.7-38.9 mg/dL
12 months-7 years: 21.7-43.3 mg/dL
8-13 years: 20.5-40.2 mg/dL
14-17 years: 20.8-43.2 mg/dL
≥18 years: 20.0-51.0 mg/dL
Interpretation
Low concentrations of ceruloplasmin are consistent with Wilson disease and warrant further investigation according to the recommended algorithm; see Wilson Disease Testing Algorithm.
Ceruloplasmin is a positive acute-phase reactant. Increases in serum ceruloplasmin have been reported during pregnancy, in women taking oral contraceptives, in hepatitis, pneumonia, tuberculosis, rheumatoid arthritis, myocardial infarction, various forms of anemia, and many obscure neurological disorders.
CPT Code Information
82390
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CERS | Ceruloplasmin, S | 2064-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CERS | Ceruloplasmin, S | 2064-4 |
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Benign Hematology Test Request (T755)
-General Request (T239)