Green serum and pregnancy: Case report

This report investigates the etiology of green serum within pregnancy.

A 24-year-old patient applied to our clinic for a routine control examination at her 25th week of pregnancy. In her repeated blood analysis, green serum was observed after centrifugation of the blood sample taken for an oral glucose tolerance test. After that, records of the patient's blood samples collected at the 9th and 12th weeks of pregnancy to verify that these serum samples were yellow were retrospectively examined.

In the literature, no green serum case without an accompanying increase in serum ceruloplasmin level has been reported. The routine blood biochemistry of alanine transaminase: 8 U/L (10-40 U/L), aspartate amino transferase: 10 U/L (10-40 U/L), gamma glutamyl transferase: 17 U/L (7-40 U/L), indirect bilirubin 5.13 μmol/L (0.0-18 μmol/L), and total bilirubin 11.9 μmol/L (0.0-24 μmol/L). The level of serum copper detected was 0.172 μmol/L (0.14-0.173 μmol/L) and of ceruloplasmin was 600 mg/L (260-630 mg/L) within the normal reference interval.

This case proves that generation of green serum in pregnancy is not only due to an increased serum ceruloplasmin but can also be caused by other factors. Additional studies need to be performed to understand the pathophysiological mechanism and future effects of the appearance of green serum during pregnancy.