A 7-Year-Old Boy Is Brought to the Physician Because of a 3-Week

A 7-year-old boy is brought to the physician because of a 3-week history of progressive fatigue. One year ago, a peripheral blood smear performed during workup of fatigue revealed erythrocytes without central pallor. His father had gallstones, for which he underwent cholecystectomy at the age of 26 years. Examination shows pallor of the mucosal membranes, mild scleral icterus. Laboratory studies show anemia, reticulocytosis, and increased indirect bilirubin. A peripheral blood smear shows red blood cells without central pallor. This patient is most likely to have which of the following additional findings?

A) Decreased lactate dehydrogenase
B) Increased haptoglobin
C) Increased mean corpuscular hemoglobin concentration
D) Increased mean corpuscular volume
E) Red blood cell inclusions

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