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Warm autoimmune hemolysis — RCPSC IM MCQ

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HardHematologyWarm autoimmune hemolysisRCPSC IM

A 44-year-old woman has fatigue, jaundice and dark urine. Hemoglobin is 68 g/L, MCV is 108 fL, reticulocytes are high, LDH is elevated, haptoglobin is undetectable and bilirubin is predominantly unconjugated. The smear shows spherocytes without schistocytes. What is the most appropriate investigation?

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Correct answer: E — Direct antiglobulin test

Extravascular hemolysis with spherocytes and no schistocytes suggests warm autoimmune hemolytic anemia. Direct antiglobulin testing confirms immune-mediated hemolysis.

Reference: Canadian hematology practice; British Society for Haematology AIHA guidance