A 10-Year-Old Boy Comes to the Office for a First

A 10-year-old boy comes to the office for a first visit.  His family recently came to the United States as political refugees.  The patient's mother says that he has required several blood product transfusions due to anemia, but she does not have prior records available with her.  On examination, the patient's temperature is 37.1 C (98.8 F) .  BMI is 21 kg/m².  Examination is notable for conjunctival pallor and moderate splenomegaly.  Laboratory results are as follows: Enzyme assays performed on circulating blood cells demonstrate low pyruvate kinase activity.  Which of the following is the most likely cause of this patient's splenomegaly?

A) Inflammatory infiltration
B) Myeloproliferative disorder
C) Passive splenic congestion
D) Presence of circulating immune complexes
E) Red pulp hyperplasia
F) Undegraded metabolite accumulation

Correct Answer:

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