A 23-year-old man comes to the emergency department due to 4 days of cramping abdominal pain. He has been feeling weak for the past 2 weeks. He tried over-the-counter antacids without relief. He is an industrial laborer with no significant medical history or known allergies. The patient's parents have hypertension, and his siblings are healthy. Temperature is 37.1 C (98.8 F) . Physical examination is unremarkable. The patient's peripheral blood smear is shown on the image below. 
Which of the following is the most likely cause of this patient's symptoms?
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