How Does Rouleaux Formation Occur?

The appearance of rouleaux may be artificially caused by a poor preparation of the smear or by viewing the slide in a thickened area. When rouleaux formation is truly present, it is caused by an increase in cathodal proteins, such as immunoglobulins and fibrinogen.

What causes Rouleaux formation?

Conditions that cause rouleaux formation include infections, multiple myeloma, Waldenström's macroglobulinemia, inflammatory and connective tissue disorders, and cancers. It also occurs in diabetes mellitus and is one of the causative factors for microvascular occlusion in diabetic retinopathy.

What is the mechanism of Rouleaux formation?

Rouleaux are stacks of erythrocytes which form because of the unique discoid shape of the cells in vertebrate body. The flat surface of the discoid RBCs give them a large surface area to make contact and stick to each other; thus, forming a rouleau.