A 30-year-old man is admitted to the hospital with neurologic impairment, fever, edema, bruising, and bleeding gums.

Manual differential counts:

WBC: 12.3 Band neutrophils: 5

RBC: 2.60 Segmented neutrophils: 64

Hgb: 8.0 Lymphocytes: 30

Hct: 23.8 Monocytes:

MCV: 91.5 Eosinophils:

MCH: 30.7 Basophils:

MCHC: 33.6 Metamyelocytes: 1

RDW: 19.9 NRBCs: 6/100 WBCs

PLT: 9.0 Moderate polychromasia

PT: 12.5 sec

aPTT: 33.1 sec

Plasma is hemolysis even with a nontraumatic venipuncture.

Describe the peripheral blood findings.

2. Interpret the coagulation screening tests.

3. What additional tests should be performed?

The results of the proposed additional studies were as follows:

Chemistry tests: consistent with renal disease (increased BUN and creatinine)

Indirect bilirubin: increased

LD: increased

Plasma-free hemoglobin: increased

Haptoglobin: not detectable

d-dimer: 0.1 g/mL

4. Based on all the data provided, what condition is most likely?

5. What information is most diagnostic?