METHADOLOGY: Serum sample of a 20year old male patient presenting to ER with complaints of altered sensorium since last 3 days and a

history of fever and yellow discolouration of the eyes since last 5 days was received in the lab for evaluation. As per protocol sample was

centrifuged and serum was obtained for evaluation in the Beckman Coulter AU480 autoanalyser. When observed the serum was found to be green

in colour

RESULT: The biochemistry report showed excessively elevated serum bilirubin ( 34 mg/dl) with predominance of unconjugated bilirubin. SGOT

was 248U/L and SGPT levels were found to be normal. Serum K+ of was 2.0 mmol/dl and elevated TLC were the other significant finding.

CONCLUSION: Occurrence of green serum is a very rare phenomenon. Even though it is theoretically possible to find green serum in pregnancy

or in long standing rheumatoid arthritis but actually it is very hard to find . In our institution several samples obtained both from the obstetrics &

gynaecology department and orthopaedic for RA cases were found to be of normal straw colour. In the above mentioned patient in view of all the

other causes being ruled out an assumption of partial biliverdin reductase deficiency could be made as it has been found to be associated in the

setting of fulminant hepatic failure mainly caused by alcoholism.