Autoagglutination vs Rouleaux formation

  • Red cell autoagglutination is the process whereby red cells clump together forming aggregates. This is seen in Waldenström’s macroglobulinemia, cold agglutinin disease and Infection with Mycoplasma Pneumonia or Infectious mononucleosis.
  • Autoagglutination represents clumping of an individual’s red blood cells (RBCs or erythrocytes) by his or her own serum due to the RBCs being coated on their surface by antibodies.
RBC Autoagglutination

RBC Autoagglutination

Clumps of red blood cells

Clumps of red blood cells

RBC Autoagglutination Direct Examination

RBC Autoagglutination Direct Examination

  • Autoagglutination should also be distinguished from “Rouleaux formation” wherein normal blood tends to form stacks on keeping, which disperses on dilution with normal saline. This occurs when the plasma protein concentration is high.
Coin Stacking RBC (Rouleaux formation)

Coin Stacking RBC (Rouleaux formation)

Rouleaux formation vs Agglutination Comparision

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