Ceruloplasmin

Historically, ceruloplasmin has been the gold-standard for assessing copper function, as it is an enzyme that is responsible for 95% of copper transport in the bloodstream. In this article we will discuss the ceruloplasmin test, standard and pregnancy specific reference ranges as well as causes of high and low values. 

Ceruloplasmin Testing

The ceruloplasmin test measures the total amount of ceruloplasmin in the bloodstream. 

The initial unbound form is called apoceruloplasmin. Apoceruloplasmin undergoes post-translational modification and folding to be able to bind to and store copper. Once mature, ceruloplasmin can bind to six copper molecules. Ceruloplasmin has a half-life of about five or six days. 

​Ceruloplasmin also has ferroxidase actions, which facilitate the conversion of ferrous iron (Fe2+) to ferric iron (Fe3+). Ferric iron can then be bound to transferrin for transport. 

Ceruloplasmin in Pregnancy

During pregnancy, there is an increase in ceruloplasmin levels that mimics the increase and changes seen in conjunction with serum copper levels. Levels begin to rise as early as four weeks of gestation. 

Ceruloplasmin levels mimic serum copper levels in the postpartum period, decreasing significantly from pregnancy ranges until six weeks postpartum. 

High Ceruloplasmin in Pregnancy

Elevated ceruloplasmin levels are seen in cases of preeclampsia and other inflammatory conditions in pregnancy. This may be due to the placental expression of ceruloplasmin, as well as inflammation and cell damage. 

Most Common Causes of High Ceruloplasmin in Pregnancy

• Iron Deficiency Anemia
• Inflammation
• Acute Infection
• Autoimmune Disease
• Rheumatoid Arthritis
• Liver Disease
• Genetics

Low Ceruloplasmin in Pregnancy

There is limited data on the application of this indice in pregnancy. Please read the Serum Copper article. ​

Most Common Causes of Low Ceruloplasmin in Pregnancy

• Copper Disease
• Wilson's Disease
• Hypothyroidism
• Iron Overload/Hemochromatosis
• Excess Zinc Supplementation
• IBD Conditions
• Gastric Surgery
• Excess Vitamin C Supplementation
• Genetics

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Medical Disclaimer:
This content is for educational purposes only and is intended for licensed medical professionals. It is based on current research, subject to change, and not intended to diagnose, treat, or prevent any medical condition. This information does not replace consultation with a qualified healthcare provider. Seek professional medical evaluation and treatment from a licensed provider. Use of this information is at your own risk.​

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