A 54-year-old female presents with fatigue and jaundice. Laboratory tests demonstrate unconjugated hyperbilirubinemia, elevated serum lactate dehydrogenase (LDH), undetectable haptoglobin, and a positive direct antiglobulin (Coombs) test. What is the diagnosis?

Answer and explanation

Correct answer: C. Autoimmune hemolytic anemia

  1. Step 1: Analyze laboratory markers: Elevated unconjugated bilirubin, high LDH, and depleted haptoglobin confirm active hemolysis.
  2. Step 2: Analyze immunological marker: A positive direct antiglobulin (Coombs) test indicates immunoglobulin and/or complement bound to red cell membranes.
  3. Step 3: Synthesize diagnosis: Immune-mediated destruction of red blood cells defines autoimmune hemolytic anemia.
Answer
Autoimmune hemolytic anemia.
Why not the others: 'Hereditary spherocytosis' also causes hemolysis but the Coombs test is negative; 'aplastic anemia' gives pancytopenia without hemolysis markers; 'iron deficiency anemia' is microcytic with low ferritin and no jaundice.

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