CASI CLINICI – Case Reports
Biochimica Clinica 2012; 36(4) 275-277
Un caso di ipercupremia
Laboratorio Analisi, Dipartimento di Patologia e Diagnostica, Azienda Ospedaliera Universitaria Integrata di Verona.
A case of hypercupremia
This report presents a case of an incidental detection of very high concentrations of serum copper in an apparently healthy adult male. Clinical and laboratory investigations for Wilson’s disease were negative. The electrophoresis of serum proteins showed a IgG monoclonal peak of 10 g/L. To clarify the nature of this unusual association (high concentration of copper and monoclonal immunoglobulin), an immunosubtraction experiment was performed: after incubation with an anti-IgG antiserum, the vast majority of serum copper was found in the IgG-anti IgG complex when the patient serum was tested; when other samples with monoclonal IgG and physiological copper concentrations were incubated, the copper remained in surnatants. The experiment allowed us to establish that the monoclonal immunoglobulin showed a high affinity for copper. Similar reports can be found in the literature; the main difference with the present case is that our patient did not show any ocular problems due to the copper deposition in the Descemet’s membrane, while in all the previously reported cases an ocular deposition of copper was observed. It is possible to speculate that in our case the affinity of the protein for copper was very high, while in other cases a lower affinity made possible the intraocular release of copper.