Coffee Colored Serum, Adverse Reaction of Eltrombopag

Serum index and macroscopic characteristics of samples can give valuable information and should be interpreted as a result. Following centrifugation of the sample, on gross inspection it was observed that the serum had a brown color. After ruling out the main causes that can cause a brown coloration, such as intravascular hemolysis or high concentrations of methemoglobin, it was noted that the patient was receiving a high-dose of Eltrombopag therapy. Eltrombopag is a non-peptide thrombopoietin receptor agonist approved for the treatment of severe aplastic anemia (SAA). The drug in solution has a brown color and at high concentrations it is capable of changing the color of the serum and may have different effects in different assays of laboratory. This article describes the case of a patient with brown serum due to the consumption of high doses of Eltrombopag that started to cause cutaneous hyperpigmentation.