24-Hour Urine Copper

Function

Copper is a vital trace mineral that serves as a cofactor for several enzymes involved in energy production, iron metabolism, and neurotransmitter synthesis. Under normal conditions, the liver regulates copper levels by excreting excess amounts into the bile. Only a very small fraction of copper is normally excreted in the urine. However, when the liver's ability to process copper is compromised, urinary excretion increases significantly.

Why it is Ordered

This test is most commonly used to diagnose or monitor Wilson Disease, a rare genetic disorder where copper accumulates in the liver, brain, and other vital organs. It is also used to evaluate symptomatic patients presenting with tremors, hepatitis, or Kayser-Fleischer rings in the eyes. Additionally, it helps monitor patients receiving 'chelating agents'—medications designed to strip excess copper from the body.

Associated Conditions

• Wilson Disease: Characterized by high urinary copper excretion (often >100 µg/24h).
• Chronic Active Hepatitis: Inflammatory liver states can disrupt copper metabolism.
• Biliary Cirrhosis: Obstruction of bile flow forces copper to be excreted through the kidneys instead of the stool.
• Nephrotic Syndrome: Severe kidney protein loss can sometimes lead to increased copper in the urine.