How do sickle cells or spherocytes interfere with the ESR?

Question

Quizplus · Accepted Answer

Sickle cells and spherocytes interfere with the ESR (Erythrocyte Sedimentation Rate) by preventing rouleaux formation, which leads to a falsely decreased ESR. Rouleaux formation is the stacking of red blood cells, which normally increases their sedimentation rate. Sickle-shaped and spherical cells do not stack as efficiently as normal disc-shaped red blood cells, thus hindering this process.

How Do Sickle Cells or Spherocytes Interfere with the ESR