26th April 2024

A 45-year-old woman presents with recurrent infections, particularly of the respiratory tract.

A 45-year-old woman presents with recurrent infections, particularly of the respiratory tract. She reports experiencing fatigue and a feeling of general malaise. She denies any significant alcohol use, weight loss, or recent travel. On examination, she appears pale and has several small bruises on her arms and legs. Her temperature is 36.9°C, and her pulse is 88 bpm.

Investigations:

Full blood count shows thrombocytosis and Howell-Jolly bodies.

Lactate dehydrogenase (LDH) is elevated.

Which is the most likely diagnosis?