55-year-old woman comes to the office due to 3 months of night sweats. She has tried using a fan and sleeping without a comforter, but she continues to awaken several nights a week with bedsheets so drenched that she has to change them. During this time, she has unintentionally lost 5 kg (11 lb). The patient traveled to Vietnam with her church group 6 months ago and wonders if she may have "caught something." She took her antimalarial pills and received her pretrip vaccinations as recommended and has not had fevers. The patient does not use tobacco, alcohol, or illicit drugs. Temperature is 37.4 C (99.4 F), blood pressure is 144/78 mm Hg, and pulse is 96/min. She has pale mucosa but no scleral icterus. There is no cervical lymphadenopathy. Cardiopulmonary examination is normal. A spleen tip is palpable when she exhales completely. Laboratory results are as follows:
Hemoglobin
8.7 g/dL
Platelets
610,000/mm3
Leukocytes
66,800/mm3
Neutrophils
32%
Bands
12%
Eosinophils
3%
Basophils
5%
Monocytes
4%
Metamyelocytes
12%
Myelocytes
23%
Lymphocytes
9%
Which of the following is expected in this patient?
A. Absence of measurable erythropoietin in urine
B. Decreased leukocyte alkaline phosphatase score
C. Positive acid-fast stain of the blood
D. Positive Coombs test
E. Positive Giemsa-stained blood smear
F. Presence of Auer rods
Hemoglobin
8.7 g/dL
Platelets
610,000/mm3
Leukocytes
66,800/mm3
Neutrophils
32%
Bands
12%
Eosinophils
3%
Basophils
5%
Monocytes
4%
Metamyelocytes
12%
Myelocytes
23%
Lymphocytes
9%
Which of the following is expected in this patient?
A. Absence of measurable erythropoietin in urine
B. Decreased leukocyte alkaline phosphatase score
C. Positive acid-fast stain of the blood
D. Positive Coombs test
E. Positive Giemsa-stained blood smear
F. Presence of Auer rods