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27th May 2023
A 19-old-female is referred to the haematology clinic having presented to her GP with a 3-month history of lethargy
A 19-old-female is referred to the haematology clinic having presented to her GP with a 3-month history of lethargy. She has no history of fevers and has had no recent travel overseas. She has a background of asthma and cerebral vein thrombosis last year. Her only medication is a salbutamol inhaler. She appears pale and jaundiced but examination is otherwise unremarkable.
Bloods tests done by her GP reveal:
| Haemoglobin | 87 g/L | Female (115-165 g/L) |
| Reticulocytes | 4.4% | (0.2-2.0%) |
| White cell count | 2 x 10⁹/L | (4.0-11.0 x 10⁹/L) |
| Platelets | 80 x 10⁹/L | (140-400 x 10⁹/L) |
| Bilirubin | 42 μmol/L | (1-17 μmol/L) |
| Lactate dehydrogenase | 590 U/L | (<250U/L) |
| Urea | 5mmol/L | (2.5-7.8 mmol/L) |
| Creatinine | 60 μmol/L | (45-84 μmol/L) |
| Direct antiglobulin test | Negative | – |
Which one of the following results would be most consistent with the likely diagnosis?
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