A 35-year-old man visited gastroenterologist for treatment of chronic HCV infection. He has sickle cell disease, hemoglobin Sβ thalassemia, with recurrent, episodic abdominal pain since childhood. Examination Complete blood count showed microcytic anemia. Total Bilirubin level: 8.5mg/dl (Normal range: 0.3- 1.2 mg/dL); Indirect bilirubin: 6.2 mg/dL (Normal range: 0.1- 1.0 mg/dL). A peripheral blood smear showed microcytic and hypochromic red cells, nucleated red cells, and sickle cells.
An abdominal radiograph (Panel A) and CT scan without contrast administration (Panel B) were obtained. What is the most likely diagnosis? *This case is from Docplexus editorial team for educative purpose only. Source: NEJM Stay Connected, the answer will be posted in the next 48h!
