A 26-year-old woman diagnosed with systemic lupus erythematosus, on treatment with hydroxychloroquine, who consults for a feeling of generalized weakness that has progressively set in over the last 15 days. The physical examination reveals cutaneous pallor and the CBC shows Hb 7.4 g/dL, Hct 31%, MCV 108. Which of the following tests will be most useful in deciding the course of action?
They give to know of a patient with SLE in treatment with Hydroxychloroquine. She has a hb of 7.4 and a MCV over 100, adding pallor and weakness, we would be dealing with a macrocytic anemia. In my opinion, the most suitable would be alternative 2, since hydroxyloroquine has been reported to decrease the absorption of folic acid, and since she has a complication of SLE, in this case, we could be dealing with an autoimmune hemolytic anemia with folic acid consumption. And for this it would be first to determine with the direct coombs.
Haptoglobin.
Coombs' test.
Vitamin B12.
Antinuclear antibodies.
In my opinion, the most suitable would be alternative 2, since hydroxyloroquine has been reported to decrease the absorption of folic acid, and since she has a complication of SLE, in this case, we could be dealing with an autoimmune hemolytic anemia with folic acid consumption. And for this it would be first to determine with the direct coombs.