What is rouleaux formation a result of?

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Rouleaux formation refers to the stacking of red blood cells in a manner resembling a stack of coins. This phenomenon is primarily caused by increased levels of circulating proteins, particularly immunoglobulins or fibrinogen, in the blood. When the concentration of these proteins rises, the normal negative charge that typically keeps red blood cells separated is altered, allowing them to adhere to one another.

In conditions such as multiple myeloma, chronic inflammation, or infections, there is an increase in certain proteins that disrupt the normal electrostatic repulsion between red blood cells, leading to rouleaux formation. This can be observed in blood smears, especially when observing the characteristics of the cells under a microscope.

The other options do not directly lead to rouleaux formation. A high white blood cell count may indicate an immune response or infection but does not cause the stacking effect of erythrocytes. A low platelet count primarily impacts clotting and bleeding tendency rather than red cell morphology. Blood clotting disorders involve abnormalities in coagulation factors and platelets that affect bleeding, but again are unrelated to the physical arrangement of red blood cells within the circulatory system.

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