A 20-year-old male presented with complaints of weakness, jaundice and hematuria. Patient also has history of frequent similar episodes in the past but most of them were self-limiting. He also gave history of consumption of something unusual. On examination mild jaundice and mild splenomegaly was noted. Lab findings revealed, Increased indirect bilirubin Hemoglobinemia and hemoglobinuria Absent haptoglobin Raised LDH Hemosiderinuria Reticulocytosis Which of the following peripheral blood smear would most likely correspond to the above condition: -

This is a case of G6PD deficiency. The food which was consumed was a beans. Image A shows spherocytes and poikilocytes - suggestive of AIHA Image B shows hypersegmented neutrophil - suggestive of megaloblastic anemia Image C shows hypochromic microcytes with pencil cells - suggestive of IDA Image D shows bite cells (degmacytes) - suggestive of G6PD deficiency. Most patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency are asymptomatic. Most of the episodes of intravascular hemolysis and consequent anemia can be triggered by infections, medicines that induce oxidative stresses, a beans, and ketoacidosis. When hemolysis is severe, patients present with weakness, tachycardia, jaundice, and hematuria. Some patients have a history of chronic hemolytic anemia.