22 year old female 8 years ago developed fever, bodyache, went to hospital her CBC showed HGB=6 with low platelet and low WBC referred to central hospital as case of acute hemolytic anemia on exame only splenomegally.ANA was positive they planned for bone marow aspiration then cancelled diagnosed to have SLE.her urine was normal with normal kidney function tests.discharged on prednisolone followed for 2 years then she stopped taking medication.
now she is 7 years without medication her CBC KFT all within normal.one month ago she developed fever, bodache, malise then she wen to primary hospital she found to have splenomegally with HGB=6 PLT-=90 ESR=120 normal kidney function, high bilirubin.she diagnosed to have acute hemolytic anemia.given pulse therapy and after that blood transfsion then she discharged fro hospital undiagnosed.
now she is one prednisolone and imuran.
kindely can you help me in diagnosis and what is further tests which i have to do.
thank u for your kind