http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/wilson-disease/
"The total serum copper concentration is made up of ceruloplasmin-bound copper and free copper, bound more loosely to albumin or smaller circulating peptides. The ceruloplasmin and therefore the ceruloplasmin copper levels are typically low in WD and may explain an overall reduction in total serum copper concentration. However, when the free (i.e., non–ceruloplasmin-bound) copper is calculated by subtracting the ceruloplasmin copper from the total serum copper level, this is usually found to be elevated, typically to more than 25 μg/dL in WD. To calculate the free copper level, the ceruloplasmin (in mg/dL) is multiplied by 3; this value is then subtracted from the total serum copper level (in μg/dL)." from Wilson's Disease
Anthony S. Tavill, MD
Published: July 2014
Last Reviewed: August 2017)
(Also of note: "Testing for the serum ceruloplasmin concentration is routinely available in all clinical laboratories; the normal range is 20 to 50 mg/dL. Approximately 95% of homozygous WD patients have values lower than 20 mg/dL. It should be noted, however, that approximately 5% of all homozygotes, whether symptomatic or not, and 15% to 50% of WD patients with liver disease, may maintain normal levels of ceruloplasmin. ")
"The total serum copper concentration is made up of ceruloplasmin-bound copper and free copper, bound more loosely to albumin or smaller circulating peptides. The ceruloplasmin and therefore the ceruloplasmin copper levels are typically low in WD and may explain an overall reduction in total serum copper concentration. However, when the free (i.e., non–ceruloplasmin-bound) copper is calculated by subtracting the ceruloplasmin copper from the total serum copper level, this is usually found to be elevated, typically to more than 25 μg/dL in WD. To calculate the free copper level, the ceruloplasmin (in mg/dL) is multiplied by 3; this value is then subtracted from the total serum copper level (in μg/dL)." from Wilson's Disease
Anthony S. Tavill, MD
Published: July 2014
Last Reviewed: August 2017)
(Also of note: "Testing for the serum ceruloplasmin concentration is routinely available in all clinical laboratories; the normal range is 20 to 50 mg/dL. Approximately 95% of homozygous WD patients have values lower than 20 mg/dL. It should be noted, however, that approximately 5% of all homozygotes, whether symptomatic or not, and 15% to 50% of WD patients with liver disease, may maintain normal levels of ceruloplasmin. ")
