09-02-2006, 08:28 AM
A previously healthy 23-year-old college student is preparing to take a 3 month trip around Asia. He has received most of his vaccinations, including the full course of the hepatitis B vaccine. He also started to take his malarial prophylaxis 2 or 3 days ago. He now reports to the emergency department with jaundice, pallor, dark-colored urine, weakness, and back pain. Blood tests indicate a profound anemia. A blood smear reveals multiple fragmented red blood cells. Which of the following is the most likely diagnosis?
(A) Autoimmune hemolytic anemia
(B) Glucose-6-phosphate dehydrogenase deficiency
© Hereditary spherocytosis
(D) Paroxysmal nocturnal hemoglobinuria
(E) Sickle cell disease