An 11-Year-Old Boy with Sickle Cell Disease Is Brought to the Emergency

An 11-year-old boy with sickle cell disease is brought to the emergency department with worsening shortness of breath, weakness, and fatigue over the past 3 days.  The patient has no fever, cough, or chest pain.  He has had many hospitalizations for treatment of acute pain and a hospitalization for acute chest syndrome.  Temperature is 36.7 C (98 F) .  Pulse oximetry is 98% on room air.  Physical examination shows a pale, tired-appearing boy.  Cardiac examination reveals tachycardia; a 3/6 systolic murmur is heard throughout the precordium.  The lungs are clear to auscultation.  The abdomen is soft and nontender with no palpable liver or spleen.  Laboratory results are as follows: Which of the following is the most likely cause of this patient's symptoms?

A) Acute chest syndrome
B) Aplastic anemia
C) Aplastic crisis
D) Autoimmune hemolytic anemia
E) Myocardial infarction
F) Splenic sequestration crisis

Correct Answer:

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