Rouleaux refers to a medical condition where red blood cells, also called erythrocytes, stick together, yielding an appearance similar to a stack of coins. This is an unhealthy condition with many possible causes including infection, cancer, and diabetes. The primary job of a red blood cell (RBC) is to transport oxygen throughout the body. When RBCs can't float freely, they can't perform this job properly, which can result in illness and disease. Symptoms of roleaux can include fatigue, poor circulation to the hands and feet, and dizziness.
Identifying rouleaux formations is made by analyzing a blood sample under a microscope. Generally, if the blood cells are largely separate, it is probably not present. If, however, the cells are clumped together forming a chain, rouleaux is likely the cause. Red blood cells clump together like this when the blood has a lot of protein in it. Usually, the high concentration of protein is of one of two types — fibrinogen or globulins. Both of these proteins are produced in the liver.
When red blood cells stack together, it is often an indication of inflammation in the body. Conditions that cause rouleaux include acute and chronic infections, inflammatory and connective tissue disorders, chronic liver disease, and cancers such as myeloma. Rouleaux also sometimes occurs in people who have diabetes and can cause small blood vessels in the eyes to become damaged, causing diabetic retinopathy. Patients receiving intravenous therapy with high molecular weight fluids, such as fibrinogen, may also experience rouleaux. Others that may exhibit the condition include people suffering from allergies and those who have undergone severe trauma.
Treatment for rouleaux varies. Natural remedies, such as nutritional supplements, may work for some people. Some studies show that ozone therapy prevents rouleaux formation. In this type of therapy, a mixture of ozone and oxygen is administered by intramuscular injection, through the rectum, or intravenously. The intravenous route requires some of the patient's blood to be removed, treated with the oxygen and ozone mixture, and then reintroduced into the patient.
