What is the preferred screen test for Wilson’s

What is the preferred screen test for Wilson’s

Urinary copper or serum ceruloplasmin?

Answers on the other posts are 50-50 for both…

Urinary cu

Liver biopsy gold standard

Always urinary copper.

Serum ceruloplasmin has basically no role in Wilson like serum Cu.

Initial and most specific investigation is Urinary Cu

Gold standard and most sensitive investigation is liver copper estimation > 200 micrograms/ g of dry liver tissue (special stain is Rhodamine/ orcein) [However not routinely done unless cirrhosis present]

Genetic assessment should also be done in family members.

24hr urinary Cu is screening IOC and liver biopsy is gold std/ confirmatory inv.( liver cu> 200mcg/gram of dry liver weight)

Ceruloplasmin

urinary cu . liver biopsy estimatiom of cu in dry wt of liver is gold std