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Dark brown serum and plasma samples: a case report.

Lora Dukic¹, Nikolina Maric², Ana-Maria Simundic^1,3

¹Department of medical laboratory diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia.

Biochemia Medica

|April 16, 2020

Summary

Unusual dark brown plasma and serum in a patient indicated intravascular hemolysis. Prompt clinical communication and reflex haptoglobin testing led to timely diagnosis and a favorable outcome.

Keywords:

case report critical care extra-analytical phase sample coloration

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Area of Science:

Clinical Pathology
Hematology
Internal Medicine

Background:

A 68-year-old female presented with nausea, vomiting, fever, abdominal pain, and jaundice.
Medical history included hypertension, hypothyroidism, squamous cell carcinoma, and prior treatment for Mycobacterium avium interstitial lung disease.

Observation:

The patient exhibited unusual dark brown coloration of citrate plasma and serum samples.
Initial laboratory findings revealed anemia (low RBC, Hb, Hct) and elevated lactate dehydrogenase (LD).

Findings:

Methaemoglobin was measured in an arterial blood gas sample.
Reflex testing confirmed intravascular hemolysis, evidenced by low haptoglobin levels.

Implications:

Brown discoloration of serum warrants immediate clinical communication.
Prompt diagnostic workup, including reflex testing, is crucial for managing intravascular hemolysis and ensuring positive patient outcomes.