Copper, Serum or Plasma
Use
It is used, along with serum ceruloplasmin and urine copper, to test for Wilson's disease and (more often) in monitoring the nutritional adequacy of parenteral or enteral nutrition, especially when copper deficiency may be suspected because of ongoing gastrointestinal losses of the element (see table). The test is done in suspected copper toxicity in premature infants when they are acutely ill and may not be able to assimilate the copper in their prescribed nutrition; in acute copper intoxications; or in “Indian childhood cirrhosis,” an illness not limited to Indian children.1 Serum copper is low in Menkes syndrome. Copper in the CSF is reported to mirror the neurotoxicity of copper in Wilson's disease.2 Liver copper is used to confirm Wilson's disease and Menkes syndrome and may be measured in liver disease of uncertain etiology. It can confirm ICC in the right setting. Liver copper rises with time in biliary cirrhosis, but does not confirm the diagnosis.
Special Instructions
Serum specimens must be separated from cells within 45 minutes of collection and transferred to a certified metal-free plastic transport tube. Plasma specimens should also be separated immediately and stored similarly for shipment to the laboratory.
Limitations
Serum ceruloplasmin binds a large portion of serum copper and is an acute-phase reactant. Both serum copper and ceruloplasmin can increase due to inflammatory conditions and estrogen. Elevations can occur in pregnancy, rheumatic conditions, and other pathologies. Copper levels are reduced by ACTH, glucocorticoids, or valproate therapy. Serum copper alone is of limited value in diagnosing Wilson's disease, Menkes syndrome, and ICC. Liver tissue copper elevations are present in Wilson's disease but may also be seen in primary biliary cirrhosis and other liver diseases.
Methodology
Mass Spectrometry
Biomarkers
LOINC Codes
- 5631-7
- 5631-7
Result Turnaround Time
2-4 days
Related Documents
For more information, please review the documents below
Specimen
Other
Volume
1 mL
Minimum Volume
0.4 mL
Container
Royal blue-top (EDTA) tube or royal blue-top without EDTA
Collection Instructions
Serum must be separated from cells within 45 minutes of collection and transferred to a certified metal-free plastic transport tube (PeopleSoft No. 111166). Plasma may be separated immediately and transferred to the same tube for shipment to the laboratory.
Storage Instructions
Maintain specimen at room temperature.
Causes for Rejection
Certified metal-free plastic transport tube not submitted; unspun royal blue-top tube from which the plasma or serum has not been removed; gel-barrier tube
Stability Requirements
| Temperature | Period |
|---|---|
| Room Temperature | 28 days |
| Refrigerated | 28 days |
| Frozen | 28 days |