question and answer
High serum copper: what's the next step?
June 2003
TESSA CLARKE, MD, of Kingston, ON, writes, "A woman had to get heavy metal testing after short-term work exposure. Her copper level was at 35.9 umol/L (normal levels should be 11-30 umol/L)." She asks, "What are the implications of this level, and should I do anything about it?"
It's difficult to make any suggestion based on just a mildly elevated serum copper. High serum copper (hypercupremia) is fairly common and shows up in a variety of disorders. Ceruloplasmin, the copper-binding protein in blood, is one of the acute phase reactants that, like fibrinogen, is elevated in many conditions. Hypercupremia occurs in normal pregnancy, oral contraceptive users, various chronic and subacute infections, malignancies, anemia (pernicious, iron-deficiency and aplastic), hyperthyroidism, hemochromatosis and collagen disorders. If your patient was tested in response to short-term exposure to copper alone and she's otherwise well, I don't think that this mild hypercupremia is going to cause any problems for her. But considering all of the factors mentioned above, she needs to be fully assessed to see if you can explain this finding. MS
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