In patients with ischaemic stroke and essential thrombocythaemia some papers suggested referring to haematology. Which patients with stroke and apparent essential thrombocythaemia should be referred?*
Almost all patients on the medical admissions unit round had a C-reactive protein result in the notes. Admittedly I am seeing the 'complex discharge patients' so the diagnoses may not be so straight forward in them but still seemed a high figure to me and unnecessary CRPs are well known in the literature. Which patients require CRP on acute admission? Is there a local policy?
1. Richard S, Perrin J, Baillot P, Lacour J, Ducrocq X. Ischaemic stroke and essential thrombocythemia: a series of 14 cases. Eur. J. Neurol. 2010. Available at: http://www.ncbi.nlm.nih.gov/pubmed/20722707 [Accessed March 21, 2011].
2. Kelly AP, Murphy AM, Hughes R. A retrospective analysis of the use of C-reactive protein assays in the management of acute medical admissions. N. Z. Med. J. 2009;122(1293):3559. Available at: http://www.ncbi.nlm.nih.gov/pubmed/19448789 [Accessed March 21, 2011].
* I've edited this entry following a discussion on #nhssm [March 23rd 2011]. It was based on a patient I had seen recently (as most clinical queries would be). The emphasis is now on my particular learning point and not any details of the case.