A 46-year-old woman presents with fatigue, jaundice and dark urine that began after a respiratory infection. She has mild splenomegaly but no renal or neurological abnormalities. Her haemoglobin is 71 g/L (115–155), reticulocyte count is 14% (0.5–2.5), lactate dehydrogenase is 980 U/L (120–250) and haptoglobin is undetectable. The blood film shows spherocytes, and the direct antiglobulin test is positive for IgG but negative for complement. Which one of the following is the most likely diagnosis?
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