A 45-year-old woman develops symptoms of shortness of breath on exertion, easy fatigue, and jaundice. On examination she is pale, and there is a palpable spleen, but no lymphadenopathy. Her hemoglobin is 9.0 g/dL, the reticulocyte count 9%, and the direct antibody test (Coombs) is positive. Which of the following bone marrow findings is most likely to be seen in this patient?
Bone marrow examination is most likely to show increased erythroid-to-myeloid ratio. Erythroid hyperplasia is common to all hemolytic anemias, and megaloblastic features only develop if they become folate deficient. A left shift only occurs if the bone marrow is under stress, like during a severe infection, and giant metamyelocytes or increased lymphocytes are not feature of an autoimmune hemolytic anemia.
megaloblastic changes
giant metamyelocytes
increased erythroid-to-myeloid ratio
increased lymphocytes
Blood