Abdulmalik Saleem, MD1, Saleh Al-Juburi, 2, Omar Ilyas, 3, Nora Sharba, 2, Yara Dababneh, MD1, Ammad Javaid. Chaudhary, MD4, Remy Arwani, MD1, Murtaza Hussain, MD5, Abu Fahad Abbasi, MD6, Ahmed Ibrahim, MD7, Ratib Mahfouz, 1, Syed-Mohammed Jafri, MD4 1Henry Ford Hospital, Detroit, MI; 2Wayne State School of Medicine, Detroit, MI; 3Michigan State University College of Human Medicine, Detroit, MI; 4Henry Ford Health, Detroit, MI; 5Sparrow Hospital, Michigan State University, Lansing, MI; 6Mercyhealth Gastroenterology Fellowship, Rockford, IL; 7Trinity Health Ann Arbor Hospital, Ypsilanti, MI Introduction: Ceruloplasmin evaluation is commonly performed in patients presenting with liver pathologies, including acute liver injury, acute liver failure, cirrhosis, and transaminitis. While low ceruloplasmin levels prompt further workup for conditions such as Wilson’s disease, disparities in follow-up care may hinder timely diagnosis. Understanding the influence of sociodemographic factors on completing this diagnostic evaluation is critical to improving outcomes. Methods: We conducted a retrospective cohort study of hospitalized patients from 5/2023 to 5/2024 with liver pathology and low ceruloplasmin levels. Liver pathologies included acute liver injury, acute liver failure, cirrhosis, and transaminitis. Patients who died during hospitalization or lacked sequelae of liver injury or transaminitis were excluded. Data collected included hepatology clinic follow-up, urinary copper testing, and liver biopsy completion. Demographic variables analyzed included age, gender, race, and Social Vulnerability Index (SVI), and their associations with workup completion. Results: A total of 403 patients were included (240 males, 163 females). Hepatology follow-up was completed by 47% of patients, while 20% completed urine copper testing. Liver biopsy was performed in 24 patients (6.0%), with only 1 biopsy yielding a diagnosis of Wilson’s disease. By race, 14/48 (29%) of African American patients completed hepatology follow-up compared to 153/287 (53%) of White patients (p = 0.006). Completion of urine copper quantification was lower in patients aged 60–90 (21/135, 16%) compared to those aged 0–30 (13/41, 32%, p = 0.038). No significant differences in follow-up or testing were observed across other SVI strata or demographic variables. Discussion: Completion rates for follow-up after identification of low ceruloplasmin levels were suboptimal. Notably, only 6% underwent liver biopsy with one case yielding a diagnosis of Wilson’s disease. Racial and age disparities were observed, with African American patients less likely to receive hepatology follow-up and older patients less likely to undergo urine copper testing. These disparities may delay diagnosis and contribute to inequities in care. Efforts to improve diagnostic adherence and address barriers in vulnerable populations are urgently needed.
Disclosures: Abdulmalik Saleem indicated no relevant financial relationships. Saleh Al-Juburi indicated no relevant financial relationships. Omar Ilyas indicated no relevant financial relationships. Nora Sharba indicated no relevant financial relationships. Yara Dababneh indicated no relevant financial relationships. Ammad Chaudhary indicated no relevant financial relationships. Remy Arwani indicated no relevant financial relationships. Murtaza Hussain indicated no relevant financial relationships. Abu Fahad Abbasi indicated no relevant financial relationships. Ahmed Ibrahim indicated no relevant financial relationships. Ratib Mahfouz indicated no relevant financial relationships. Syed-Mohammed Jafri: Abbvie – Speakers Bureau. Gilead – Speakers Bureau. Intercept – Speakers Bureau. Ironwood – Speakers Bureau. Takeda – Speakers Bureau.
Abdulmalik Saleem, MD1, Saleh Al-Juburi, 2, Omar Ilyas, 3, Nora Sharba, 2, Yara Dababneh, MD1, Ammad Javaid. Chaudhary, MD4, Remy Arwani, MD1, Murtaza Hussain, MD5, Abu Fahad Abbasi, MD6, Ahmed Ibrahim, MD7, Ratib Mahfouz, 1, Syed-Mohammed Jafri, MD4. P1503 - Missed Opportunities: Disparities in Follow-Up and Diagnostic Completion for Low Ceruloplasmin Levels in Hospitalized Patients, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
