Leukocyte erythrocyte rosettes

Leukocyte erythrocyte rosettes

Rare but usually seen in autoimmune haemolytic anaemia (AIHA)

More likely to form with cells of the monocyte

Form via interaction of surface Fc receptors with IgG1 or IgG3 decorated erythrocytes

Rosettes have been proposed to represent a physiologic intermediate in extravascular red blood cell destruction and strongly predict clinical AIHA

There existed a laboratory test for rosette formation between patient erythrocytes and sheep monocytes (the “monocyte monolayer assay”) that had many limitations, but greater predictive value for clinically significant haemolysis than the standard Coombs’ test

Credit: Schulman et al, Am J Hematology 2012 https://onlinelibrary.wiley.com/doi/full/10.1002/ajh.23277

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