A 20-Year-Old Man Is Evaluated for Recurrent Episodes of Jaundice

A 20-year-old man is evaluated for recurrent episodes of jaundice.  He was separated from his parents at a young age and is unaware of any family medical history.  The patient resided in several foster homes throughout his childhood but currently lives alone.  His temperature is 36.7 C (98 F) , blood pressure is 120/80 mm Hg, and pulse is 72/min.  Physical examination shows pallor, icterus, and mild splenomegaly.  There is no lymphadenopathy or hepatomegaly.  The remainder of the physical examination is normal.  Laboratory test results are as follows: When the patient's red blood cells are incubated in a hypotonic solution with glycerol, hemoglobin is released.  The control sample does not release hemoglobin.  This patient is at greatest risk of developing which of the following?

A) Autoimmune disease
B) Autoinfarction of the spleen
C) Avascular necrosis of the femur
D) Hemolysis from consumption of fava beans
E) Pigmented gallstones

Correct Answer:

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