Review Question - QID 108682

A 34-year-old woman presents to the emergency department with a 2 month history of difficulty walking. She noticed that she has become less steady on her feet over the last few months and fell in her bathroom this morning while washing her face. Her past medical history includes morbid obesity status post Roux-En-Y gastric bypass surgery 2 years ago, hypertension, hyperlipidemia, diabetes mellitus, and osteoarthritis. She says that she has been able to lose about 60 pounds since her gastric bypass surgery. She also endorses fatigue and weakness for which she went to her primary care provider last month and received iron supplements. In addition to the iron supplements, her home medications include atorvastatin, metformin, and occasional ibuprofen. Her temperature is 97.6°F (36.4°C), blood pressure is 134/84 mmHg, pulse is 87/min, and respirations are 12/min. On neurological exam, the patient has increased spasticity in her legs bilaterally and a positive Romberg sign. Laboratory tests are performed which reveal the following:

Leukocyte count: 6,200/mm^3
Hemoglobin: 8.7 g/dL
Hematocrit: 25%
Mean corpuscular volume: 102 µm^3
Platelet count: 202,000/mm^3
Reticulocyte index (RI): 1.2%

A bone marrow biopsy is performed and the results are shown in Figure A. This patient would most likely have which of the following additional findings?