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PTD - 188

Test Directory -  Caeruloplasmin

Clinical Indications

Low caeruloplasmin is found in most cases of Wilson's disease. Copper accumulation produces clinical features (hepatic disease, neurological signs, Kayser-Fleischer rings) usually in late childhood / early adulthood. Decreased levels also found in severe liver disease, malnutrition, malabsorption and nephrotic syndrome.

Request Form

Combined Pathology Blood form (Yellow/Black)


Referred test: Analysed by the Immunology Department, Addenbrookes Hospital if specific criteria met.

Specific Criteria

Investigation of early Liver Disease with or without neurological symptoms. Investigation of suspected Wilson's or Menkes' disease or if specifically requested by a Consultant. Investigation will normally only be undertaken if patient less than 40 years of age.

Patient Preparation

None required

Turnaround Time

2 weeks




2 ml


Yellow top (SST) tube or

Paediatric orange top (lithium-heparin)

Causes for Rejection

Not meeting specific criteria for analysis. 

Reference Range


Age Range

Caeruloplasmin g/L


0 to 30 days

0.06 - 0.26


30 days to 1 year

0.15 - 0.46


1 to 3 years

0.27 - 0.55


3 to 6  years

0.28 - 0.55


6 to 9 years

0.24 - 0.50


9 to 12 years

0.21 - 0.50


Over 12 years

0.20 - 0.50


Ref: Addenbrookes (adapted from Soldin et. al. Clin.Chem. 1997: 43; S199)


95% of patients with Wilson's disease have a low caeruloplasmin level. Decreased levels are also found in severe liver disease, malnutrition, malabsorption and nephrotic syndrome. Elevated values are seen in infections, malignancy and trauma.

Lab. Handling

Processing: Test code CAER. Aliquot (MPA) and store at 4C in separating fridge (CB39).

Referral: Send or NOCAE and save in separating freezer (CB40) at -20C, saved frozen rack.

Version 1.2 / February 2015       Approved by: Consultant Biochemist