title: Serum ceruloplasmin and ferroxidase activity are not decreased in hepatic failure related to alcoholic cirrhosis: clinical and pathophysiological implications.
abstract: BACKGROUND
  A decrease in serum ceruloplasmin (Cp), a protein involved in iron metabolism through its ferroxidase activity, is classically claimed to be observed in severe hepatic failure of non-wilsonian chronic liver disease and therefore to be a confounding factor for the diagnosis of Wilson's disease. Moreover, a simultaneous decrease in ferroxidase activity could be hypothesized as playing a role in the development of the hepatic siderosis frequently observed in advanced chronic liver diseases. The aim of this study was to test the validity of these two statements.
  
  
  METHODS
  This study investigated Cp, determined by immunonephelometry, and its ferroxidase 1 activity determined by Erel's method in 33 male patients with severe alcoholic cirrhosis compared with 66 healthy male volunteers, selected on strict criteria. Each patient was age-matched with two controls. Nonparametric tests were used for statistical analysis.
  
  
  RESULTS
  The mean values of Cp were significantly higher in cirrhotic patients as compared with control subjects. A significant elevation of Cp was also observed in the subgroup of 11 cirrhotic patients who had normal serum C-reactive protein levels. The mean values of ferroxidase 1 activity were similar to those obtained in control subjects.
  
  
  CONCLUSIONS
  Low serum Cp should not be expected in severe hepatic cirrhosis of non-wilsonian origin. Hepatic siderosis in advanced chronic liver disease is likely to be unrelated to decreased ferroxidase activity.
authors.affiliation: Service des Maladies du Foie and INSERM U-522, University Hospital Pontchaillou, Rennes, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Le Lan
authors.forename: Martine
authors.initials: M
authors.lastname: Ropert
authors.forename: Fabrice
authors.initials: F
authors.lastname: Lainé
authors.forename: Muriel
authors.initials: M
authors.lastname: Medevielle
authors.forename: Christine
authors.initials: C
authors.lastname: Jard
authors.forename: Michel
authors.initials: M
authors.lastname: Pouchard
authors.forename: André
authors.initials: A
authors.lastname: Le Treut
authors.forename: Romain
authors.initials: R
authors.lastname: Moirand
authors.forename: Olivier
authors.initials: O
authors.lastname: Loréal
authors.forename: Pierre
authors.initials: P
authors.lastname: Brissot
mesh_terms: D000328:Adult; D002570:Ceruloplasmin / Q000378:metabolism*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood*; D017093:Liver Failure / Q000097:blood*; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric
chemical_list: D002570:Ceruloplasmin