<prompt> True about wilsons disease -Increase in urinary copper and increased serum ceruloplasmin and copperIncreased serum ceruloplasmin levels with increased urinary copperElevated hepatic copper level and increased serum ceruloplasmin levelsIncreased in urinary copper and decreased serum ceruloplasmin  <response>: Ans. is d i.e., Increased in urinary copper and decreased serum ceruloplasmin Diagnosis of Wilson disease Diagnosis includes the demonstration of a reduced ceruloplasmin level, increased urinary excretion of copper, the presence of Kayser-Fleischer rings in the cornea of the eyes, and an elevated hepatic copper level, in the appropriate clinical setting. o Ceruloplasmin Serum glycoprotein that contains six copper atoms. Copper incorporation into ceruloplasmin is impared in Wilsons disease. 95 of homozygotes have levels 20mgdL rarely are levels 30 mgdL. May also be low in other hypoproteinemic states May be low in 20 of asymptomatic heterozygotes o Serum free copper unbound copper Greater than 25 mg in symptomatic pts normal 10 o Slit lamp detection of Kayser Fleischer Rings o 24 hour urinary copper excretion May exceed 100 mg24 h-use metal free container False with sign. Proteinuria ceruloplasmin loss o Liver biopsy 250 gg copper dry weight in homozygotes normal 50. Cholestatic diseases PBCPSC may have elevated hepatic copper dry weight. 