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?

  1. A)Decreased haptoglobin and elevated serum lactate dehydrogenaseGABARITO
  2. B)Decreased reticulocyte count and elevated ferritin
  3. C)Increased mean corpuscular hemoglobin and decreased unconjugated bilirubin
  4. D)Increased direct bilirubin with normal unconjugated bilirubin
  5. 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 →

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