Intrinsic hemolytic normocytic anemia Quiz: Ace Your Exams

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A 29 year-old African-American man comes to the emergency department complaining of fatigue, jaundice, back pain, and dark urine for the last 5 days. He recently returned from a trip to Kenya, during which time he took malaria prophylaxis medication. The patient’s medical history is non-contributory. However, he states that his maternal uncle had similar symptoms when treated with specific types of antibiotics. Temperature is 37.1°C (98.8°F), pulse is 72/min, respirations are 14/min, and blood pressure is 126/78 mmHg. Physical examination shows scleral icterus. Laboratory tests are obtained, and the results are shown below.

A table lists hematologic lab values: Hemoglobin 8.6 g/dL, MCV 85 fL, Platelet count 190,000/mm³, Leukocyte count 10,000/mm³, Reticulocyte count 8.5%, Haptoglobin 24 mg/dL.
Which of the following is most likely seen on this patient’s peripheral blood smear?

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