Serum copper measurement is used for the laboratory diagnosis of Wilson's disease, primary biliary cirrhosis and primary sclerosing cholangitis.
Copper (Cu) is an essential trace element, essential for the synthesis of hemoglobin and the activation of respiratory chain enzymes. In normal conditions, more than 95% of serum copper is bound to seruloplasmin, the remainder being loosely bound to albumin.
Decreased serum copper levels are usually due to excessive intake of iron or zinc and rarely to the real lack of dietary copper. The decrease in copper levels results in a serious developmental disorder and a reduction in erythropoiesis. Low concentrations of copper in the blood are also observed in hepatocellular degeneration (Wilson's disease) due to the reduced synthesis of seruloplasmin. In Wilson's disease, albumin-bound copper may actually increase, but ceruloplasmin copper is low, resulting in reduced serum copper levels. However, during the acute phase of Wilson's disease, seruloplasmin and copper may be normal due to increased release of seruloplasmin. Without seruloplasmin for copper transport, Wilson's disease results in the accumulation of copper in the tissues of the brain, eyes, kidneys and liver. One of the features of this disease is the presence of Kayser-Fleischer rings around the iris of the eye, which are created by deposition of copper. Other disorders associated with decreased serum copper concentrations include malnutrition, hypoproteinemia, malabsorption, nephrotic syndrome, Menkes disease, and excessive intake of zinc-containing supplements (zinc interferes with the normal absorption of copper from the gastrointestinal tract).
Elevated serum copper levels have been identified in primary biliary cirrhosis, primary sclerosing cholangitis, hemochromatosis, malignant diseases (including leukemia), thyroid toxicity and various infections. Serum copper concentrations may also be elevated in patients taking contraceptives or estrogens during pregnancy.
Possible Interpretations of Pathological Values
- Increase: Alzheimer's disease, anemia (aplastic, malignant, megoblastic pregnancy, iron deficiency), cirrhosis (biliary), elevated levels of C-reactive protein, glomerulonemia, hypochromatosis, Hodgkin's disease , Löfgren syndrome, lymphoma, myocardial infarction, workers in copper processing plants, pellagra, pregnancy, rheumatoid arthritis, sarcoidosis, systemic lupus erythematosus, ulcerative colitis. Medications: carbamazepine, estrogen and oral contraceptives, heroin, phenobarbital, phenytoin.
- Decrease: Burns, Down Syndrome, Intestinal Nutrition (Long Term), Hypoproteinemia, kwashiorkor, Malabsorption, Menkes Syndrome, Kidney Disease, Wilson's Disease. Medications: Nifedipine
Laboratory test results are the most important parameter for the diagnosis and monitoring of all pathological conditions. 70%-80% of diagnostic decisions are based on laboratory tests. Correct interpretation of laboratory results allows a doctor to distinguish "healthy" from "diseased".
Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be interpreted in relation to each individual case and family history, clinical findings and the results of other laboratory tests and information. Your personal physician should explain the importance of your test results.
At Diagnostiki Athinon we answer any questions you may have about the test you perform in our laboratory and we contact your doctor to get the best possible medical care.