Problem:
A 7-month-old girl presents to the ED with jaundice. Her parents report her pediatrician is also concerned about her delayed growth and development. On exam, the child is fussy but able to be consoled by her parents. Her spleen is palpated below the left costal margin, and she has abdominal distention without ascites. A peripheral smear is shown above. Which of the following contributes to immune deficiency in patients with her suspected disorder? Bone marrow hyperplasia Cerebrovascular disease Delayed puberty Functional asplenia Vaso-occlusive pain crises