apfcbAPFCB eNewscoAPFCB News Volume 4, Issue 1MultidisciplinaryEnglishJan-Jun, 2025NNY2025031ArticlesThe enigma surrounding coffee-colored serumEnglishY7679Dr. SailujaMaharjanEnglishNDr. SristiUpadhyayEnglishYDr. SrinivasChakravarthyEnglishY10.62772/APFCB-News.2025.1.3Abnormal discoloration of body fluids like serum or urine has been reported in the literature as a pharmacological adverse effect. Herein we report a patient with coffee-colored serum as an adverse effect of eltrombopag. Therefore, we alert the laboratory professionals and highlight the importance of visual inspection of the serum sample in a clinical laboratory and explore the possibilities. Furthermore, eltrombopag at high dose (200mg) can interfere with bilirubin assay based on the methodology used in the detection systemsEnglishBilirubin, Brown serum, Coffee colored serum, Eltrombopag, Interferencehttps://apfcb.org/APFCB_News/abstract?id=20References16191. Dukic L, Maric N, Simundic AM. Dark brown serum and plasma samples: a case report. Biochem Med (Zagreb) 2020;30(2):021002. 2. Farell CJ, Carter AC. Serum indices: managing assay interference. Annals of clinical biochemistry. 2016;53. 527-38. 3. Poventud-Fuentes I, Garnett E, Despotovic J, Devaraj S. Interference of eltrombopag with bilirubin measurements on the Vitros 5600 analyzer. J Clin Lab Anal. 2021 Aug;35(8):e23796 4. Rojas CR, Santamaria CJ, Belda ODP, Noguero EM. Coffee Colored Serum, Adverse Reaction of Eltrombopag. The electronic Journal of the International Federation of Clinical Chemistry. 2023(34); 258-61. 5. Afzal N. A Unique Case of Dark Brown Plasma: Why Colour Variation should be Reported.JCPSP Case Rep 2023; 1:60-62. 6. Prus-CzarneckaZ, Fuezery A, Noga T, et al. BMJ Case Rep 2023;16:e252885. 7. Cardamone D, Milone MC, Glaser L, Frey NV, Kricka LJ. Eltrombopag and serum of a different hue. Arch Pathol Lab Med. 2013 Sep;137(9):1175. 8. Rodgers GM, Kurtti AL, Gilreath JA. Are eltrombopag plasma and skin hyperpigmentation related? The eyes have it. Am J Hematol. 2019;94:394and;ndash;395. 9. Cheng THT, Tsui TKC, Kwok JSS, Lit LCW, Wong EYL, Kam RKT, Grote-Koska D, Staaden A, Okada H, Fuke N, Wong RSM, Li CK, Chan MHM. Comprehensive characterization and resolution of discrepant spectrophotometric bilirubin results in patients on eltrombopag therapy. Clin Chem Lab Med. 2020 Sep 25;58(10):1713-1723 10. Atay H, Kelkitli E, Turgut M. A rare side effect: eltrombopag associated hyperpigmentation. G Ital Dermatol Venereol. 2020 Dec;155(6):803-804.