Inductively coupled plasma/mass spectrometry (ICP/MS)

Serum ceruloplasmin is an acute-phase reactant type protein, and since it binds a large portion of serum copper, both serum copper and ceruloplasmin increase under the influence of inflammatory conditions and estrogen. Serum copper is, therefore, elevated in pregnancy, in patients on estrogens and estrogen-containing contraceptive drugs, in rheumatoid arthritis, and a number of pathologic entities. It may be low with low serum proteins as in nephrosis, malabsorption, and malnutrition without necessarily reflecting inadequate liver copper stores.