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Question category: Haematology

A 28 year old female presents feeling very tired, short of breath on exertion and palpitations for the last few days. She has recently had a course of cefalexin for a Urinary tract infection. She is otherwise normally fit and well. On examination the patient looks pale and the sclerae appear yellow. She is tachycardic. Bloods reveal a low haemoglobin with a high reticulocyte count and evidence of spherocytes on the blood film. Her bilirubin was elevated (majority being unconjugated) but the rest of her LFTs were normal and her LDH was elevated. A direct Coombs test was positive.

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