Erythrocyte money string formation appears as red blood cells stacked like coins (coins) in a string. The erythrocyte coin formation is easily separated from the erythrocyte aggregates by tapping the glass slide. When shaken, the erythrocyte coin formation disappears into a single scattered erythrocyte. The morphology and appearance return to normal. This does not happen with erythrocyte aggregates. Early or atypical cases of erythrocyte string-like appearance are easily misdiagnosed as chronic cited nephritis, pyelonephritis, aplastic anemia, rheumatoid arthritis division from, hepatic sclerosis, metastases, etc. Transplantation is therefore essential for middle-aged and elderly patients with unexplained rapid hematocrit, anemia, renal insufficiency, recurrent infections, and bone and joint pain to undergo divisional serum protein electrophoresis, bone marrow aspiration with skeletal X-ray for confirmation of the diagnosis. Erythrocyte money string formation is manifested by red blood cells resembling coins (coins) stacked in a string. By tapping the glass slides, the erythrocyte coin formation is easily separated from the erythrocyte aggregates. When shaken, the erythrocyte coin formation disappears into a single scattered erythrocyte. The morphology and appearance return to normal. This does not happen with erythrocyte aggregates. When the concentration of macromolecular proteins in plasma increases and the negative charge on the surface of red blood cells decreases, the electrostatic repulsion between red blood cells decreases, resulting in increased aggregation of red blood cells, which can easily form strings or piles. In patients with multiple myeloma nephropathy, blood smear examination may show red blood cells in the shape of strings of money, and later white blood cells and platelets are also reduced. The red blood cells may interfere with blood grouping. A variety of suboptimal symptoms can also be diagnosed microscopically with lemon, stringy or piles of red blood cells.