Ceruloplasmin Test

The ceruloplasmin test is used to measure the amount of ceruloplasmin, a liver-produced protein that carries copper through the blood. It is performed on a blood sample. It is also known as the CP test and ceruloplasmin serum test.

Copper is an important mineral that supports healthy nerves, blood vessels, and immunity. It also helps your body produce energy, make use of iron, and produce melanin (the pigment that gives your eyes and skin their colour). Too much ceruloplasmin causes Wilson disease, a condition in which the body cannot get rid of excess copper. Low ceruloplasmin levels occur in conditions such as malnutrition and malabsorption, where the body cannot absorb enough nutrients from food.

Therefore, doctors use the ceruloplasmin test to diagnose and monitor conditions caused by too little or too much copper in the body.

You may be advised to get the ceruloplasmin blood test​ if you are experiencing the following symptoms of Wilson disease:

• Pain in the abdomen
• Nausea and vomiting
• Itchy skin
• Trembling movements
• Stiffness of muscles
• Fluid build-up in your belly and legs
• Jaundice (a condition characterised by the yellowing of skin and eyes)

You may also be recommended to get the test if you have the following symptoms of too little copper:

• Abnormally low levels of neutrophils (a type of white blood cell)
• Tiredness
• Paleness of skin
• Tingling in your hands and feet
• Osteoporosis (a condition in which the bones become weak)

Testing may also be helpful in babies who are experiencing the following symptoms of Menkes syndrome:

• Seizures (uncontrolled shaking episodes)
• Delayed weight gain and growth
• Floppy muscles
• Problems with the hair, such as loss of colour, thinness, easy breakage, and easy tangling

The following categories of people are advised to take the ceruloplasmin test:

• Individuals with abnormal copper levels – In such cases, regular ceruloplasmin testing can help monitor the progression of the condition and the effectiveness of the treatment.
• Individuals with liver diseases – Individuals with liver diseases, such as cirrhosis and chronic hepatitis, may have high levels of ceruloplasmin.

The ceruloplasmin test can be used along with other tests to help diagnose and monitor certain conditions, such as

• Wilson disease – This is an uncommon genetic disorder in which the body is unable to remove excess copper, leading to liver problems, tremors, and difficulty with movement.
• Malnutrition – This is a condition in which your diet has insufficient amounts of key vitamins, minerals, and nutrients.
• Malabsorption – This is a condition in which your body cannot properly absorb nutrients from the food you eat. Coeliac disease is a common disorder that causes malabsorption.
• Menkes disease – This is an uncommon disease in which babies cannot properly utilise the copper in their bodies.
• Nephrotic syndrome – This is a condition marked by protein in the urine, higher than normal cholesterol and triglyceride levels, increased risk of blood clotting, and swelling in the body.
• Severe liver disease – This includes serious liver conditions caused by viruses, drugs, poison, alcohol, and cancer.

What to Expect Before the Ceruloplasmin Test

No fasting is required for a standalone Ceruloplasmin test. You can eat and drink normally. However, if it is part of a broader package that includes fasting tests, your doctor may advise fasting for 8-12 hours. Avoid strenuous exercise for 24 hours before the test, as intense physical activity can temporarily raise Ceruloplasmin levels and affect interpretation. Always inform your doctor about any ongoing medications.

What to Expect During the Blood Collection

A phlebotomist cleans the skin with an antiseptic, then places an elastic band around your upper arm to make the veins easier to access. A small needle is inserted into the vein; you may feel a brief pinch. Blood is collected into a labelled tube in under a minute.

What to Expect After the Ceruloplasmin Test

A small cotton swab and bandage are placed over the site to stop any minor bleeding. You can return to normal activities immediately. Minor bruising is normal and disappears quickly. If dizzy, sit and rest for a few minutes.

In the ceruloplasmin test, the primary parameter being measured is:

• The level of ceruloplasmin in a sample of blood.

The ceruloplasmin test normal range is indicated in the table below.

Note: The normal range may vary slightly depending on the laboratory and individual health conditions.

The table below provides a general interpretation of the ceruloplasmin test results based on whether the levels are low or high.

Note: Test results must always be interpreted along with symptoms, clinical history, and findings from other tests.

Risks:

The ceruloplasmin test is generally safe and involves minimal risk. You may experience slight pain when the needle is inserted or mild bruising afterwards, which usually resolves spontaneously.

Limitations:

• The ceruloplasmin test alone cannot be used to diagnose any condition. Other tests, such as the copper test, must be used to interpret the results.
• The test results might be affected by pregnancy, birth control pills, and oestrogen therapy used to treat menopause.

Depending on your symptoms and results, your doctor might recommend certain additional tests to better understand your condition. These include:

• Copper blood test
• Copper urine test
• Ophthalmologic slit lamp examination
• Liver biopsy
• Albumin blood test
• Chymotrypsin in stool
• Prealbumin blood test
• Stool elastase test
• Xylose test