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Wilson Disease Screening Panel, Serum
0020598
Ordering Recommendation
Preferred panel to diagnose conditions of copper overload in symptomatic patients or individuals with a family history of Wilson disease (WD). Directly measured, free (non-ceruloplasmin bound) fraction of copper is included. To monitor response to copper-reducing therapies, refer to Copper, Serum Free (Direct) (0020596).
Mnemonic
WILSON D
Methodology
Quantitative Immunoturbidimetry/Quantitative Inductively Coupled Plasma-Mass Spectrometry
Performed
Refer to individual components
Reported
1-5 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
Specimen Required
Patient Preparation
Diet, medication, and nutritional supplements may introduce interfering substances. Patient should be encouraged to discontinue nutritional supplements, vitamins, minerals, and non-essential over-the-counter medications (upon the advice of their physician).  
Collect
Royal blue (no additive).  
Specimen Preparation
Centrifuge and pour off serum ASAP or within 2 hours of collection. Do not allow serum to remain on cells. Transfer 4 mL serum (Min: 2.5 mL) to an ARUP Trace Element-Free Transport Tube (ARUP supply #43116). Available online through eSupply using ARUP Connect or contact ARUP Client Services at (800) 522-2787.  
Storage/Transport Temperature
Frozen.  
Unacceptable Conditions
Separator tubes. Specimens that are not separated from the red cells or clot.  
Remarks
 
Stability
After separation from cells: Ambient: 8 hours; Refrigerated: 72 hours; Frozen: 1 month  
Reference Interval
Test Number
Components
Reference Interval
0020096Copper, Serum or PlasmaEffective November 14, 2011
Age
Male
Female
0-10 years75-153 µg/dL75-153 µg/dL
11 years-12 years64-132 µg/dL64-132 µg/dL
13 years-18 years57-129 µg/dL57-129 µg/dL
19 years and older70-140 µg/dL80-155 µg/dL

0050160Ceruloplasmin
6 months-6 years18-37 mg/dL
7-17 years20-43 mg/dL
18 years and older17-54 mg/dL

0020596Copper, Serum Free (Direct)0.0-10.0 µg/dL

Interpretive Data
Free copper (direct) is determined with serum ultrafiltrate. In Wilson disease or other conditions of copper overload, serum ceruloplasmin is usually low and free copper (direct) is usually high. Other tests used to diagnosis Wilson disease include 24-hour urine copper, and hepatic copper. Slit lamp examination for Kayser-Fleischer rings and genetic testing may also be helpful.


Note
Elevated results from tubes not certified metal-free may be due to contamination.  Elevated levels should be confirmed with a second specimen collected in a metal-free tube.
CPT Code(s)
82390; 82525 x2
Components
Component Test Code*Component Chart NameLOINC
0020096Copper, Serum/Plasma5631-7
0020596Copper, Serum Free (Direct)5631-7
0050160Ceruloplasmin2064-4
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • ceruloplasmin
  • Copper free and direct
  • Copper Panel
  • Copper, Free
  • CU free and direct
  • Direct and free copper
  • Free Copper Index
  • Free CU index