Ceruloplasmin, Acute Phase Protein

What sample is needed for Ceruloplasmin?

1. This test is done in the serum.
2. The test is done with a fresh sample.
3. The sample can be stored for 3 days at 4 °C.
4. For 4 weeks, it can be stored at -20 °C.

What are the precautions for Ceruloplasmin?

1. Avoid hemolyzed or lipemic serum.
2. Ceruloplasmin is affected by infection and liver function.
3. Birth control pills increase ceruloplasmin and pregnancy.

What are the indications for Ceruloplasmin?

1. Advised on chronic inflammations.
2. This is done to diagnose Wilson’s disease.
3. To diagnose an accumulation of copper in the liver, eyes, and other organs.

How will you discuss the Pathophysiology of Ceruloplasmin?

1. Ceruloplasmin is a major copper-carrying protein in the blood.

2. Ceruloplasmin is an α2-globulin and glycoprotein (7.5% carbohydrate) made by the liver.
3. Ceruloplasmin contains approximately 95% of the total copper and gives it a blue color.
   1. 95% of the copper is bound to Ceruloplasmin.
   2. Its molecular mass is 134,000.
   3. This is an acute-phase protein with enzymatic activity (peroxidase activity).

What is the role of Ceruloplasmin as an acute-phase protein?

1. Ceruloplasmin reduces the number of WBCs attached to the endothelium.
2. In one experiment, it was found that ceruloplasmin may act as an anti-inflammatory agent by reducing the number of PMNs attaching to the endothelium and by serving as an extracellular scavenger of superoxide.
3. Elevated levels of minor acute phase reactants, such as ceruloplasmin, have been related to an increased risk of cardiovascular disease.
4. Ceruloplasmin helps monitor chronic inflammation in patients, and in these patients, there is an increased risk of cardiovascular disease, particularly among those undergoing dialysis.
5. This is a decrease in Wilson’s disease.
   1. The decreased ceruloplasmin and blood copper concentrations, along with an increased urine copper level, indicate Wilson’s disease.
6. This is an increase in acute and chronic inflammation.

What is the normal ceruloplasmin (source 1)?

• Another source gives this normal value:
  • Male = 36.0 ± 5.6 mg/dL (2.38 ± 0.37 µmol/L).
  • Female = 40.9  ±  6.8 mg/dL (2.71  ± o.45 µmol/L).
• Source 4
  • 25 to 63 mg/dL  (250 to 630 mg/L) by nephelometry.

What is the Critical value of Ceruloplasmin? =  <20mg/dL is abnormal.

What are the causes of an increased level of ceruloplasmin?

1. The latter half of the pregnancy.
2. Acute and chronic infections.
3. In myocardial infarction.
4. Thyrotoxicosis.
5. Leukemia and cancers.
6. In liver cirrhosis.

Questions and answers: