A 21-year-old male college student presents with a 3-day history of jaundice, dyspnea on exertion, and fatigue. He reports a sore throat and malaise for the past 2 weeks. Vital signs show temperature 38.2°C (100.8°F), heart rate 92/min, blood pressure 128/76 mmHg, respiratory rate 18/min. On examination, he has scleral icterus, pharyngeal erythema without exudate, and a palpable spleen 2 cm below the left costal margin. Laboratory studies reveal: Hemoglobin: 8.1 g/dL Mean corpuscular volume: 88 fL Reticulocyte count: 8.2% (reference: 0.5-2%) Leukocyte count: 9,200/mm³ Platelet count: 195,000/mm³ Total bilirubin: 4.2 mg/dL Direct Coombs test: Positive Heterophile antibody (monospot): Positive Which of the following additional laboratory abnormalities would most strongly support the diagnosis of hemolytic anemia in this patient?
- A)Decreased haptoglobin and elevated serum lactate dehydrogenaseGABARITO
- B)Decreased reticulocyte count and elevated ferritin
- C)Increased mean corpuscular hemoglobin and decreased unconjugated bilirubin
- D)Increased direct bilirubin with normal unconjugated bilirubin
- E)Decreased serum creatinine and elevated alkaline phosphatase
Explicação
In autoimmune hemolytic anemia (AIHA) secondary to EBV infection, complement-mediated hemolysis causes rapid destruction of RBCs. This results in: (1) Decreased haptoglobin—the acute phase protein is consumed when it binds free hemoglobin released from lysed R... Ver explicação completa e trilha adaptativa →