Red blood cells forming rouleaux

  • Jonathan Armstrong
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Red blood cells forming rouleaux. Jonathan Armstrong. Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Source: Wellcome Collection.

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Red blood cells form rouleaux at low flow rates, greatly increasing blood viscosity. They can also form more readily in some disease states such as cancer, rheumatoid conditions and inflammation, where certain proteins cause the red blood cells to stick together more readily. These formations increase the erythrocyte sedimentation rate (ESR).

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