Department

Toxicology

Preferred Sample Type

Copper

Suitable Specimen Types

  • Blood in Dark Blue Top Tube
  • Li Hep Plasma
Minimum 60 μl blood (1 x Paed Lith Hep tube)

Sample Processing in Laboratory

Separate without delay to avoid haemolysis

-Centrifuge and separate

For paediatric investigations, when the sample volume is limited, please collect blood into Sarstedt lithium heparin tubes (a minimum of 25 μl plasma is needed)

Sample Preparation

Centrifuge blood specimen.

Turnaround Time

3 working days

Sample Stability

Usual

Copper

General Information

Copper is an important trace element which funtions as a catalytic component of numerous enzymes and is also a structural component of other important proteins.

A deficiency of copper has been noted in a number of conditions including malnourishment, malabsorption syndromes, prematurity, cardiovascular disease and Menkes syndrome. Copper deficiency presents as a microcytic hypochromic anaemia with marked neutropenia, which is resistant to iron therapy. Children and neonates on diets deficient in copper have ineffective collagen synthesis, and may develop bone disease. As the liver contains substantial stores of copper, frank clinical copper deficiency is unusual, but has been reported in malnourished children and in adults on long term parenteral nutrition.

Raised values are seen in inflammatory states and with steroid hormone therapy. When investigating Wilson Disease, plasma/serum copper measurement is only of value as an addition to plasma caeruloplasmin concentration and 24 hour urinary copper excretion.

 

Caeruloplasmin and 24 hour urinary copper should be used for the initial investigation of Wilson's Disease, due to the many potential problems of interpreting the serum copper concentration.

Patient Preparation

For paediatric investigations, when the sample volume is limited, please collect blood into Sarstedt lithium heparin tubes (a minimum of 25 μl plasma is needed)

Notes

Copper test results must be evaluated in context and are usually compared to caeruloplasmin concentration. Abnormal copper results are not diagnostic of a specific condition; they indicate the need for further investigation. Interpretation can be complicated by the fact that caeruloplasmin is an acute phase reactant – it may be elevated whenever inflammation or severe infections are present. Both caeruloplasmin and copper are also increased during pregnancyand with oestrogen and oral contraceptive use.

Test results may include:

Low blood copper concentrations along with increased urine copper excretion, low caeruloplasmin concentrations, and increased hepatic copper are typically seen with Wilson’s disease.

Increased blood and urine copper concentrations and normal or increased caeruloplasmin concentration may indicate exposure to excess copper or may be associated with conditions that decrease copper excretion – such as liver disease. Increased hepatic copper may be present with chronic conditions.

Decreased blood and urine copper concentrations and decreased caeruloplasmin may indicate a copper deficiency.

Reference Range

Copper (serum) (CU)

µmol/L

0 – <4 months

1.4 – 7.2

4 – <6 months

3.9 – 17.3

6 months – <9 years

11.1-27.4

9 years – <13 years

11.2-23.7

13 years – 19 years

11.0-22.5

> 19 years

11.0-25.1

Pregnancy: 16 weeks to term

27 - 40

Wilson’s Disease

< 4

(Source: SAS Trace Element Update, 2018)

Specifications

  • EQA Status:

    UK Guildford NEQAS Trace Elements Scheme

The laboratories at Heartlands Hospital, Good Hope Hospital and Solihull Hospital form part of the services provided by University Hospitals Birmingham and are UKAS (United Kingdom Accreditation Service) accredited to the ISO 15189:2012 standard. For a list of accredited tests and other information please visit the UKAS website using the following link: https://www.ukas.com/find-an-organisation/

  • Heartlands, Good Hope and Solihull Hospital pathology laboratories are a UKAS accredited medical laboratory No.8217
  • United Kingdom Health Security Agency laboratory is a UKAS accredited medical laboratory No.8213

Tests not appearing on the UKAS Schedule of Accreditation currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.

For further test information, please visit the test database: http://www.heftpathology.com/frontpage/test-database.html.

Protection of personal information - Laboratory Medicine comply with the Trust Data Protection policy and have procedures in place to allow the Directorate and its employees to comply with the Data Protection act  1998 and associated best practice and guidance.

For further information contact Louise Fallon, Quality Manager, 0121 424 1235

UKAS HEFT