Systemic acute phase reaction promoted by this oxidative stress will increase inflammatory cytokines, C-reactive protein, fibrinogen, blood cell count, blood viscositym, and rouleaux formation
. These things lead to rise in ESR values.
In erythrocytes, morphological alterations were anisocytosis, poikilocytosis, target cells, microcytes, spherocytes, polychromic RBCs, howell jolly bodies, immature nucleated RBCs and rouleaux formation
. In leukocytes, alterations were neutrophilia, eosinophilia, lymphocytosis, regenerative shift to left, degenerative shift to left, toxic granules in neutrophils, shift to right, lymphopenia and neutopenia.
Dilated pelvic veins appear on sonography as a cluster of elongated and tubular cystic lesions in the adnexa along the broad ligament and demonstrate low level echoes due to sluggish flow and visible red blood cell rouleaux formation
. This can be confirmed on color Doppler images and help differentiate it from hydrosalpinx.
This results in decreased flow velocities and rouleaux formation
of red blood cells, which is seen as "spontaneous echo contrast" on echocardiography.
Morphology showed normochromic, anisocytosis, Rouleaux formation
, circulating blast cells with Auer rods, bicytopenia with leukocytosis, neutrophils: 0.7%, lymphocytes: 23%, monocytes: 03%, Blasts: 67%.
A peripheral blood smear clearly exhibited rouleaux formation (Figure 1(a)).
Caption: FIGURE 1: Peripheral blood smears from (a) Case 1 and (b) Case 2, which exhibit rouleaux formation of the red blood cells.
Complete blood cell count showed a macrocytic anemia with a hemoglobin concentration of 97 g/L, rouleaux formation
, and circulating plasmacytes.
Increased rouleaux formation
was observed on peripheral smear examination in all cases; 87% of the cases showed a normocytic normochromic anaemia.
The patient's blood smear showed obvious erythrocyte rouleaux formation
in association with 6% circulating plasma cells.