Biochemia Medica, Vol. 30 No. 2, 2020.
Other
https://doi.org/10.11613/BM.2020.021002
Dark brown serum and plasma samples: a case report
Lora Dukic
orcid.org/0000-0001-6690-7551
; Department of medical laboratory diagnostics, University Hospital „Sveti Duh“, Zagreb, Croatia
Nikolina Maric
; Department of emergency and intensive medicine, University Hospital „Sveti Duh“, Zagreb, Croatia
Ana-Maria Simundic
orcid.org/0000-0002-2391-5241
; Department of medical laboratory diagnostics, University Hospital „Sveti Duh“, Zagreb, Croatia; Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
Abstract
This case report describes occurrence of unusual, dark brown coloration of citrate plasma and serum samples in a female 68 years old patient admitted
into Emergency department (ED).
Patient complained of nausea and vomiting, fever up to 38.9°C, colicky pain in abdomen, diminished urinary output and yellowish skin tone. Her
medical history included arterial hypertension, hypothyroidism and facial squamous cell carcinoma. For previous two years, she was treated with
tuberculostatic therapy for Mycobacterium avium positive interstitial lung disease. Regular follow-up showed no signs of active disease. Upon admission
to ED, complete blood count (CBC) analysis showed low red blood count (RBC) (3.76 x1012/L (reference interval (RI) 3.86 – 5.08 x1012/L)), low
haemoglobin (Hb) concentration (111 g/L (RI 119 - 157 g/L)) and low haematocrit (Hct) (0.310 L/L (RI 0.360 – 0.470 L/L)). Biochemistry analytes were
high, with foremost lactate dehydrogenase (LD) activity (2900 U/L, RI < 240 U/L). After communication with the clinician, methaemoglobin measured
in arterial blood gas sample was reported. Patient was admitted to the Intensive care unit and upon reflex testing of haptoglobin, intravascular
haemolysis was confirmed. This case indicates that every case of brown coloration of the serum must be promptly communicated to the clinician.
Reflex testing assured timely diagnosis and favourable patient outcome.
Keywords
case report; critical care; extra-analytical phase; sample coloration
Hrčak ID:
238915
URI
Publication date:
15.6.2020.
Visits: 682 *