Fortschr Neurol Psychiatr 2010; 78(10): 582-589
DOI: 10.1055/s-0029-1245540
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Die Bedeutung des Coeruloplasmins für die Differenzialdiagnose neuropsychiatrischer Störungen

The Role of Ceruloplasmin in the Differential Diagnosis of Neuropsychiatric DisordersB. J. Connemann1 , C. Schönfeldt-Lecuona1 , H.-J. Maxon1 , W. Kratzer2 , J. Kassubek3
  • 1Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
  • 2Zentrum für Innere Medizin, I. Medizinische Klinik, Universitätsklinikum Ulm
  • 3Klinik für Neurologie, Universitätsklinikum Ulm, RKU
Further Information

Publication History

Publication Date:
01 September 2010 (online)

Zusammenfassung

Das psychiatrische Interesse am Coeruloplasmin geht ursprünglich auf Beobachtungen erhöhten Serumkupfers bei Schizophrenien zurück. Das immunturbidimetrisch bestimmte Serum-Coeruloplasmin ist jedoch, anscheinend im Gegensatz zur Coeruloplasmin-assoziierten Oxidaseaktivität, bei den Schizophrenien nicht erhöht. Da das Coeruloplasmin als Akut-Phase-Protein bei zahlreichen Prozessen ansteigt, ist eine erhöhte Coeruloplasmin-Serumkonzentration aus neuropsychiatrischer Sicht wenig aussagekräftig. Dagegen scheint die Coeruloplasmin-Oxidaseaktivität bei Morbus Alzheimer reduziert zu sein, und niedrige immunturbidimetrisch bestimmte Coeruloplasmin-Serumkonzentrationen oder ein Fehlen des Serum-Coeruloplasmins werden bei Morbus Wilson, Menkes Disease und Acoeruloplasminämie angetroffen, 3 erblichen neurodegenerativen Systemerkrankungen mit ausgeprägter genotypischer, vor allem aber auch phänotypischer Variabilität. Insbesondere Morbus Wilson kann über lange Zeiträume eine ausschließlich psychische Symptomatik zeigen. Heterozygote Merkmalsträger von Morbus Wilson und Acoeruloplasminämie zeigen niedrige Coeruloplasmin-Serumkonzentrationen ohne wesentliche weitere körperliche Befunde. Ob psychische Störungen auch bei den hiervon Betroffenen oder, allgemeiner, bei niedriger Coeruloplasmin-Serumkonzentration ohne manifesten Morbus Wilson gehäuft auftreten, wurde bisher nicht untersucht.

Abstract

The blue copper protein ceruloplasmin has been of interest to psychiatrists for decades following Heilmeyer’s observation of elevated serum copper levels in schizophrenic patients. Immunoturbidimetry, however, does not yield elevated serum ceruloplasmin concentrations in schizophrenia while ceruloplasmin-related oxidase activity appears to be elevated in patients with schizophrenia and reduced in patients with Alzheimer’s disease. Low serum concentrations of immunoturbidimetrically measured ceruloplasmin, and of oxidase activity, are typical of Wilson’s disease, Menkes’ disease, and aceruloplasminemia, three familial neurodegenerative disorders of pronounced variability, with regard to both genotype and phenotype. Especially patients with Wilson’s disease may exhibit behavioural symptoms only over a long period. Heterozygous carriers of Wilson’s disease and aceruloplasminaemia may have low serum ceruloplasmin concentrations; they will not develop somatic symptoms, but the significance of these carrier states, or of ”hypoceruloplasminaemia”, with regard to mental disorders is unknown.

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PD Dr. Bernhard J. Connemann

Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm

Leimgrubenweg 12

89075 Ulm

Email: bernhard.connemann@uni-ulm.de

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