A 3-Year-Old Boy Who Recently Emigrated from Ghana Is Brought

A 3-year-old boy who recently emigrated from Ghana is brought to the physician because of a 5-hour history of pain and swelling in his hands. He has had similar episodes in the past. The boy attends day care, but his parents are unsure about any sick contacts.  His family history is significant for an older brother who died of pneumococcal sepsis at age 5.  The patient appears distressed. His temperature is 38.1°C (100.5°F) . Physical examination shows pallor. The dorsum of his hands and fingers are swollen, warm, and tender to palpation. Which of the following is most likely abnormal in this patient?

A) Left ventricular systolic function
B) Serum albumin
C) Serum C4 complement fraction
D) Serum haptoglobin
E) Systemic venous pressure
F) Urine cortisol excretion

Correct Answer:

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