Test Catalog

Test Id : CERS

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Ceruloplasmin, Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Investigation of patients with possible Wilson disease

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

For information see Wilson Disease Testing Algorithm.

Method Name
A short description of the method used to perform the test

Nephelometric Assay

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Ceruloplasmin, S

Aliases
Lists additional common names for a test, as an aid in searching

Copper Oxidase

Ferroxidase

Kayser-Fleischer Ring

Wilson's Disease

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

For information see Wilson Disease Testing Algorithm.

Specimen Type
Describes the specimen type validated for testing

Serum

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

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.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

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)

-Gastroenterology and Hepatology Test Request (T728)

-Biochemical Genetics Test Request (T798)

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

0.5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 7 days
Frozen 30 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Investigation of patients with possible Wilson disease

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

For information see Wilson Disease Testing Algorithm.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

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
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

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

> or =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

> or =18 years: 20.0-51.0 mg/dL

Interpretation
Provides information to assist in interpretation of the test results

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.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Ceruloplasmin is a positive acute-phase reactant; therefore, levels are elevated in cases of inflammation (as in chronic hepatitis or active infection). Consequently, ceruloplasmin levels are not always extremely low in patients with Wilson disease.

 

Values vary considerably from patient to patient and may be in the normal range in some patients with Wilson disease (indicating a different primary defect).

 

Birth control pills and pregnancy increase ceruloplasmin levels.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Wilson Tang WH, Wu Y, Hartiala J, et al: Clinical and genetic association of serum ceruloplasmin with cardiovascular risk. Arterioscler Thromb Vasc Biol. 2012 Feb;32(2):516-522

2. Dadu RT, Dodge R, Nambi V, et al: Ceruloplasmin and heart failure in the Atherosclerosis Risk in Communities study. Circ Heart Fail. 2013 Sep 1;6(5):936-943

3. Cox DW, Tumer Z, Roberts EA: Copper transport disorders: Wilson's disease and Menkes disease. Inborn Metabolic Disease. Fernandes J, Sandubray JM, VandenBerghe F, eds. Springer-Verlag; 2000:385-391

4. Sontakke AN, More U: Changes in serum ceruloplasmin levels with commonly used methods of contraception. Indian J Clin Biochem. 2004 Jan:19(1):102-104

5. Schilsky ML: Wilson disease: Diagnosis, treatment, and follow-up. Clin Liver Dis. 2017 Nov;21(4):755-767

6. Hermann W: Classification and differential diagnosis of Wilson's disease. Ann Transl Med. 2019 Apr;7(Suppl 2):S63

Method Description
Describes how the test is performed and provides a method-specific reference

Human ceruloplasmin forms a precipitate with a specific antiserum, which is then measured nephelometrically.(Package insert: Ceruloplasmin. Siemens; 08/2018)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

1 to 7 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

82390

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
CERS Ceruloplasmin, S 2064-4
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
CERS Ceruloplasmin, S 2064-4

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports