A 29-year-old woman comes to the physician because of a facial rash and pain inside her mouth for one week. She has a 4-year history of intermittent, generalized arthritis. Physical examination shows erythema on the cheeks and an ulcer on the left buccal mucosa. Temperature is 101 F. She works at a pet store. Laboratory studies are shown:
Hemoglobin: 9 g/dL
Hematocrit: 27%
WBC: 3,500/μL
Platelets: 100,000/μL
ESR: Elevated
Which of the following is the most likely explanation for these hematologic findings?
Aplastic anemia
Bacterial infection
Peripheral destruction
Plasma cell dyscrasia
T cell-mediated apoptosis
Viral illness
