The erythrocyte sedimentation rate, rouleaux formation and hyperviscosity syndrome. Theory and fact.

Uncomplicated hyperviscosity syndrome secondary to hypergammaglobulinemic states seems to be associated with rouleaux formation on the peripheral blood film and a normal or near normal erythrocyte sedimentation rate. Conversely, the concomitant finding of rouleaux formation with a normal erythrocyte sedimentation rate is highly suggestive of the hyperviscosity syndrome. The theoretical and factual justifications for this hypothesis are presented.