Review of her urine studies from several recent hos-pitalizations revealed blood on dipstick with few or absent red blood cells per high-power field on microscopic examination, consistent with hemoglobinuria. Further studies revealed an elevated reticulocyte count and lac-tate dehydrogenase level, low levels of haptoglobulin and iron, normal 24-hour urine protein and complement levels, a negative Coombs test result, a leukocyte alkaline phosphatase score of zero (normal range, 11 to 95), and a positive sucrose lysis test result.
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