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		<rdfs:label>WBR0745</rdfs:label>
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		<property:AnswerA rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Several family members with cholecystectomy</property:AnswerA>
		<property:AnswerAExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Hereditary spherocytosis (HS) is an autosomal dominant genetic disorder characterized by the hemolysis and increased bilirubin that prediposes affected patients to gallbladder stones.  Since the disease is autosomal dominant, a positive family history of HS is typical and thus a positive family history of cholecystectomy should raise the suspicion of HS in young patients presenting with jaundice and anemia.</property:AnswerAExp>
		<property:AnswerB rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Personal history of macrosomia at birth</property:AnswerB>
		<property:AnswerBExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Macrosomia is not associated with hereditary spherocytosis. The latter is a hereditary disorder.</property:AnswerBExp>
		<property:AnswerC rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Maternal history of pre-eclampsia during pregnancy</property:AnswerC>
		<property:AnswerCExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Pre-eclampsia does not predispose patients to hereditary spherocytosis.  The latter is a hereditary disorder.</property:AnswerCExp>
		<property:AnswerD rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Maternal use of amoxicillin during pregnancy</property:AnswerD>
		<property:AnswerDExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Amoxicillin in considered safe in pregnancy.</property:AnswerDExp>
		<property:AnswerE rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Recent history of fava bean intake</property:AnswerE>
		<property:AnswerEExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Fava bean intake is associated with hemolysis in patients with G6PD deficiency.</property:AnswerEExp>
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		<property:Explanation rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Hereditary spherocytosis (HS) is an autosomal dominant genetic disorder characterized by round, deformed red blood cells (RBC) due to red cell membrane defect.  The RBC loses its biconcave shape and takes on a spherical shape that predisposes it to rupture and splenic sequestration.  These RBC abnormalities are responsible for the clinical manifestations of the disease: anemia and jaundice secondary to the hemolysis, and splenomegaly secondary to sequestration of RBCs in the spleen. Blood work-up typically reveals low hemoglobin with elevated MCHC, and elevated levels of unconjugated bilirubin. Diagnosis of HS is by peripheral smear that shows the pathognomonic spherical RBCs. For most patients with HS, splenectomy is curative. Because HS is an autosomal dominant disorder, patients usually have a positive family history of the disease. In these patients, elevated bilirubin due to hemolysis predisposes to gallbladder stones that increase the risk of cholecystitis. As such, patients may present with a very positive family history of cholecystectomies.&lt;br/&gt;
'''Educational Objective:''' Young patients presenting with jaundice, splenomegaly, and anemia with a positive family history for cholecystectomies should raise the suspicion for hereditary spherocytosis.&lt;br/&gt;
'''References:''' Shah S, Vega R. Hereditary spherocytosis. Pediatr Rev. 2004;25(5):168-72.</property:Explanation>
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