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Year : 2020  |  Volume : 63  |  Issue : 1  |  Page : 142-143
Green plasma in a female blood donor taking oral contraceptive pill


1 Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant, Dehradun, Uttarakhand, India
2 Department of Pathology, Fatima Hospital, Mother Teresa Road, Padri Bazar PO. Gorakhpur, Uttar Pradesh, India

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Date of Web Publication31-Jan-2020
 

How to cite this article:
Raturi M, Rai D. Green plasma in a female blood donor taking oral contraceptive pill. Indian J Pathol Microbiol 2020;63:142-3

How to cite this URL:
Raturi M, Rai D. Green plasma in a female blood donor taking oral contraceptive pill. Indian J Pathol Microbiol [serial online] 2020 [cited 2020 Feb 17];63:142-3. Available from: http://www.ijpmonline.org/text.asp?2020/63/1/142/277373




Green discoloration of a plasma unit was observed while preparing components in our blood-bank laboratory [Figure 1]. The 25-year-old married female donor telephonically gave a history of oral contraceptive pills (OCP) intake in the form of MALA–N (norgestrel 0.03 mg and ethinyl estradiol 30 μg]) once daily. However, the last dose of OCP taken was a week prior to donation. She gave no history of joint pains, morning stiffness, and/or medications other than OCP. Her dietary history did not reveal anything significant. Culture of the unit was sterile.
Figure 1: Comparative photograph of plasma units showing (a) abnormal green color, (b) normal yellow color

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Various etiologies have been described previously for green discoloration of plasma units. Elevated ceruloplasmin levels may occur with increased serum copper levels for example, in rheumatoid arthritis and in estrogenic states such as pregnancy and OCP use.[1],[2],[3],[4] Discoloration can also result from cryophilic contaminants such as pyocyanin or pyoverdin pigments of Pseudomonas species,[5] or from excess sulfhemoglobin formed because of intake of drugs like sulphonamides.[6]

Ceruloplasmin levels were not estimated in our case. Although visual assessment guidelines by Canadian Blood Services state that green-discolored units because of OCP intake are acceptable for transfusion,[7] in India, such units are usually discarded for safety reasons. There is a need for national guidelines on transfusion implications of discolored plasma, once serious causes like bacterial overgrowth have been rigorously excluded.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Scheinberg IH, Cook CD, Murphy JA. Concentration of copper and ceruloplasmin in maternal and infant plasma at delivery. J Clin Invest 1954;33:963.  Back to cited text no. 1
    
2.
Koskelo P, Kekki N, Virkkunen N, Lassus M, Somer T. Serum ceruloplasmin concentration in rheumatoid arthritis, ankylosing spondylitis, psoriasis, and sarcoidosis. Acta Rheum Scand 1966;12:261-6.  Back to cited text no. 2
    
3.
Wolf P, Enlander D, Dalziel J, Swenson J. Green plasma in blood donors. N Eng J Med 1969;281:205.  Back to cited text no. 3
    
4.
Raghuwanshi B, Pehlajani NK. Green colour donor plasma. Indian J Anaesth 2016;60:778-9.  Back to cited text no. 4
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5.
Elkassabany NM, Meny GM, Doria RR, Marcucci C. Green plasma – revisited. Anesthesiology 2008;108:764-5.  Back to cited text no. 5
    
6.
Flexman AM, Vicario GD, Schwarz SKW. Dark green blood in the operating theatre. Lancet 2007;369:1972.  Back to cited text no. 6
    
7.
Visual Assessment Guide, Canadian blood Services, 2009. Available from: https://professionaleducation.blood.ca/sites/msi/files/VAG_en.pdf. [Last accessed on 2019 Apr 09].  Back to cited text no. 7
    

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Correspondence Address:
Manish Raturi
Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant, Dehradun, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJPM.IJPM_287_19

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