HY USMLE Q #968 – Heme / Gastro

A 9-year-old boy is brought to the physician for a 2-day history of yellow eyes. He recently recovered from an upper respiratory tract viral infection. He did not receive any medications. Laboratory studies show:

Hemoglobin                                                                                                                 10 g/dL
Total bilirubin                                                                                                              2 mg/dL
Direct antiglobulin test                                                                                         (+)
Blood smear                                                                                                                 Spherocytes

Which of the following is the most likely explanation for these findings?

  Abnormality of cytoskeletal ankyrin
  Autoimmune hemolytic anemia
  Benign deficiency of conjugation enzyme
  Diminution of hepatic bilirubin export
  X-linked recessive enzyme deficiency