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Blood test result

About 6 weeks ago I had my routine blood test and a strange result showed "Rouleaux formation present, red cells show Ancanthocytosis " The GP didn't seemed concerned and said to have another blood test in 6 weeks, which I did and it didn't show up this time, no further follow up, so didn't get to speak to the GP as to what it was. I did google it and it seems like some form of anaemia? I did ask on the PAS site 6 weeks ago but only had one response and they hadn't heard of it. I do have borderline low B12 but within range, and my platelets are always below range this time it was 120 [ range 150-400 ] yet the GP doesn't seem concerned, could it be related to long term use of steroids ?

5 Replies

Did you see these links? They explain rouleaux formation quite well and simply:

You'll see it is caused by raised blood protein levels - and is indicative of chronic inflammation in the form of the ESR. No surprise there then.

This link is for the acanthocytosis, with pictures:

and if you go right down to the bottom of this link you will see that, despite the long list of awful sounding diseases further up the page, storage of blood can also be a reason for the formation of cells that look like this.

Maybe the blood sample wasn't stored properly on its way to the hospital lab - that is enough to affect ESR and possibly also the acanthocytosis. Anyway - whatever the reason, they didn't see it in the repeat which always the correct thing to do - never a knee jerk reaction on the basis of one test, repeat it first. I am surprised your platelets haven't increased with the pred though.


Thank you PMRpro

I found the healthoracle link quite easy to follow, some other links that I found were too complicated for my fuzzy brain. I will read it again to absorb it more, perhaps like you say my blood wasn't stored properly. I usually have my blood taken in the morning and it doesn't get collected till around 4pm, I did notice that on the same result my ESR was only 9 that's the lowest it's been in many years, very strange the CRP was 9 [ ESR has gone up since to 18 ]

I have been taking pred for 16 years and my platelets have been below range for several years.


In that case the ESR result is probably fairly meaningless - an ESR must be set up within 4 hours of the blood sample being taken or it isn't accurate. I'm also not quite sure what that sort of delay will do to rouleaux formation since if the blood isn't being collected until 4pm the likelihood of it being processed even the same day is minimal. A better test than the ESR would be plasma viscosity but at least they are also doing a CRP which is also less sensitive to such factors.

If there is anything you still don't get just ask - and I'll try to put it into simpler language. It is all relatively easy for me understand but not for the person who has never worked in a hospital lab so it is nothing to be embarrassed about - I can't do make-up ;-)


Thank you PMRpro , Like you I don't do make up, but have been known to bake a decent cake, and a bread pudding,

Our small village surgery. [ lucky to still have one ] does all blood tests in the morning by the part time health care assistant, she's very good and previously trained as a paramedic, perhaps I could ask for a later appointment so as the blood isn't hanging about too long, I cant be the only one in the village who has to have regular ESR tests so they are also hanging around all day not good for a result.

I'm now wondering about my ANCA test that came back negative yet I had all the signs of WG.


Blood for anything fancy like that is really so much better being done at the hospital. Mind you, even hospital phlebotomy clinics get things wrong!

We're spoiled - it's a 5 minute drive to the hospital and they call the lab to come down to the clinic and fetch the "specials" - in fact, it's a 5 min walk to the station in the village and the train actually stops "in" the hospital and the phlebotomy clinic is the nearest department!

I used to be a dab hand at baking - raised a lot of money on that basis! Now down to making 8 mincepies per year - and that is only because they can't be bought here - wouldn't bother in the UK!


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