In Menke's disease, copper levels are low due to inability to absorb copper, resulting in ceruloplasmin deficiency.

• A. High copper with elevated ceruloplasmin
• B. Low copper with ceruloplasmin deficiency
• C. Normal copper with normal ceruloplasmin
• D. Low copper with normal ceruloplasmin

Answer: (B)

The key idea is that Menke's disease stems from a defect in copper transport, which means copper is not absorbed or distributed properly in the body. Copper is essential for making ceruloplasmin, a copper-containing protein produced by the liver. When copper absorption is impaired, there isn’t enough copper available to incorporate into ceruloplasmin, so ceruloplasmin levels fall as well as copper levels in the blood.

That’s why the pattern described—low copper with low ceruloplasmin—fits Menke's disease best. If copper were high or ceruloplasmin were normal or high, that would point to other conditions and not to this copper-transport defect.