Copper is an essential trace element. It is required for hemoglobin synthesis and is a constituent of the cytochrome oxidase system. The most important abnormality in copper metabolism is Wilson’s Disease. Subnormal concentrations are found in patients with hypoproteinemia, e.g., protein malnutrition, protein malabsorption syndrome, nephrosis and Menkes syndrome. Above normal concentration are found in a number of acute and chronic disease, such as malignant diseases (including leukemia), hemochromatosis, biliary cirrhosis, thyrotoxicosis, and various infections. serum copper levels are also high in patients taking contraceptive or estrogens.