Clinical Laboratory Hematology 3rd Edition by Shirlyn McKenzie, Lynne Williams

Exercise 9

Nancy, a 28-year-old female, makes an appointment with her physician because she feels tired all the time and is short of breath with minor exertion. She indicates that the symptoms have been ongoing for about 3 weeks. She has no known history of chronic diseases.
Consider the initial laboratory tests that should be performed to evaluate this patient's condition based on clinical history and symptoms.
Nancy's initial complete blood count (CBC) shows a hemoglobin value of 7.0 g/dL and a hematocrit of 21%. Her white blood cell (WBC) count and platelet count are within the reference interval.
When examining the Nancy's peripheral blood smear, the laboratory professional noted that spherocytes were present. The reticulocyte count was elevated. The laboratory professional called the blood bank and found that the DAT on Nancy was positive with polyspecific AHG, anti-IgG but negative with anticomplement.
Two days later, Nancy's hemoglobin dropped to 50 g/L. The physician ordered several more tests. She had a positive IAT, and the antibody reacted with all cells including her own. Other test results indicated that this patient had systemic lupus erythematosus.
What is the relationship of Nancy's primary disease, systemic lupus erythematosus, and her anemia?