Which characteristic is associated with multiple myeloma?

Multiple myeloma is characterized by the clonal proliferation of plasma cells in the bone marrow, leading to a variety of hematological abnormalities and organ dysfunction. One of the hallmark laboratory findings associated with multiple myeloma is the presence of rouleaux formation of red blood cells. This phenomenon occurs due to increased levels of serum proteins, particularly monoclonal immunoglobulins produced by malignant plasma cells. The excess proteins reduce the zeta potential of red blood cells, promoting their stacking and leading to rouleaux formation that can be observed on a blood smear.

Other aspects of multiple myeloma can include anemia, which is typically normocytic, and may lead to a decrease in normal red blood cell production due to bone marrow involvement. However, the specificity of rouleaux formation in this context makes it a distinctive characteristic of the disease. The presence of anti-parietal cell antibodies is associated with autoimmune conditions like pernicious anemia, not multiple myeloma. Anemia in multiple myeloma can be present in various forms, and a decrease in serum creatinine is not typical; rather, kidney dysfunction is common due to the high levels of filth-producing proteins and resultant light chain cast nephropathy. Thus, rouleaux formation serves as