A 23-year-old man with no prior medical history presents with jaundice, dark urine, and severe back pain 2 days after starting trimethoprim-sulfamethoxazole for cellulitis. Vital signs show BP 118/76, HR 102, RR 20, temp 37.8°C, SpO2 98%. Laboratory studies reveal hemoglobin 9.2 g/dL, decreased haptoglobin, elevated lactate dehydrogenase, and elevated indirect bilirubin. Peripheral blood smear demonstrates bite cells. Reticulocyte count is appropriately elevated. Which of the following best explains this patient's disorder?
- A)Impaired polymerization of fibrin
- B)Impaired conversion of folate to tetrahydrofolate
- C)Production of antibodies against platelet glycoprotein IIb IIIa
- D)Defective anchoring proteins in the red cell membrane
- E)Impaired generation of reduced glutathione in erythrocytesGABARITO
Explicação
Impaired generation of reduced glutathione in erythrocytes is correct. Glucose 6 phosphate dehydrogenase deficiency reduces NADPH production in the pentose phosphate pathway, leaving red cells vulnerable to oxidant injury from sulfa drugs, infections, and fava... Ver explicação completa e trilha adaptativa →