Rouleaux

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Rouleaux (sing. rouleau) are stacks or aggregations of red blood cells (RBCs) that form due to the unique discoid shape of the cells in vertebrates. The flat surface of the discoid RBCs gives them a large surface area to make contact with and stick to each other; thus forming a rouleau. They occur when the plasma protein concentration is high, and, because of them, the ESR (erythrocyte sedimentation rate) is also increased. This is a nonspecific indicator of the presence of disease. 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. So, the presence of rouleaux can also be a cause of disease because it will restrict the flow of blood throughout the body because capillaries can only accept free-flowing singular and independent red blood cells. The...

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