16th February 2024

A 34-year-old female presents to the acute medical unit with a 3-week history of abdominal pain

A 34-year-old female presents to the acute medical unit with a 3-week history of abdominal pain and increasing abdominal distension. He also noted that his sclera was yellow 4 days prior to admission. Ultrasound examination reveals absent flow within the hepatic veins. The portal vein remained patent.

Blood tests reveal mildly deranged LFTs with mild hyperbilirubinemia. Full blood count shows pancytopenia with raised serum LDH and haptoglobins. Direct Coombs test is negative. Peripheral blood smear shows red cell agglutination, thrombocytopenia, and leukopenia. Urinalysis revealed haemoglobinuria without raised nitrites. Urine cultures were negative.

Given the underlying diagnosis, which investigation findings confirm the diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.