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Copper (Cu), Serum

Serum copper measurement is used in the laboratory to diagnose Wilson's disease, primary biliary cirrhosis, and primary sclerosing cholangitis.

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Copper (Cu) is an essential trace element for synthesizing hemoglobin and activating respiratory chain enzymes. In normal conditions, more than 95% of serum copper is bound to ceruloplasmin, and the remainder is 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 severe 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 ceruloplasmin. In Wilson's disease, albumin-bound copper may increase, but ceruloplasmin copper is low, reducing serum copper levels. However, during the acute phase of Wilson's disease, ceruloplasmin and copper may be average due to the increased release of ceruloplasmin. Without ceruloplasmin for copper transport, Wilson's disease results in copper accumulation in the brain, eyes, kidneys, and liver tissues. One of the features of this disease is the presence of Kayser-Fleischer rings around the eye's iris, which are created by the 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, megaloblastic of pregnancy, iron deficiency), cirrhosis (biliary), elevated C-reactive protein, glomerulonephritis, hemochromatosis, Hodgkin's disease, hyperestrogenemia, hypothyroidism, hypertension, hyperthyroidism, infection, leukemia, Löfgren's 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, enteral feeding (long term), hypoproteinemia, kwashiorkor, malabsorption, Menkes syndrome (kinky hair), nephrosis, Wilson disease. Medications: Nifedipine
Important Note

Laboratory test results are crucial for diagnosing and monitoring all pathological conditions. 70% and 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 solely based on the numerical result of a single analysis. They should be interpreted concerning each case, family history, clinical findings, and the results of other laboratory tests and information. Your 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 contact your doctor to ensure you receive the best possible medical care.

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