Websites on the thrombocytopenias

Websites related to this week's Clinical Review selected by Dr Keith Barnard.

DETAILED GUIDELINES

There was a time when I would have said guidelines like these were over the top in primary care, but these days there are probably quite a few GPs who might be developing a special interest in haematology.

If so, you will want to read this 25-page PDF about the investigation and management of ITP in adults, children and pregnancy. It is pretty detailed and reasonably up to date, being published in 2003.

Why go there: It provides all you need to know.
Downside: No images.
Information from: British Journal of Haematology.
Address: www.bcshguidelines.com/pdf/BJH574.pdf

ARTICLE OVERVIEW

Disseminated intravascular coagulation is not something we see every day, but cases do occur and it is worth knowing about. Here you will find a sensibly brief account and a decent diagram that explains the complex pathophysiology.

There is also a list of possible causes and a table of clinical and laboratory findings.

Treatment is not that effective and is hospital based but, as the article concludes, awareness of the clinical settings in which this condition can occur and its diagnostic features helps doctors to recognise it as early as possible.

Why go there: All the essential detail is provided.
Downside: Presentation in this long, strip format is poor.
Information from: Postgraduate Medicine online.
Address: www.postgradmed.com/issues/2002/03_02/messmore.htm

PATIENT INFORMATION

This site is a disappointment, but it was the only UK charity I could find that is aimed at ITP sufferers and their carers. The site covers all ages, but much of the information is aimed at parents. It is a shame the site is so unimaginatively presented. If you want a factsheet, you can't download it. Instead you have to write in, which seems ridiculous to me.

And for a condition that presents so visually, where are the illustrations?

Whoever designed this needs to liven it up.

Why go there: Little in the way of alternatives.
Downside: Visually really dull.
Information from: ITP Support Association.
Address: www.itpsupport.org.uk/

PATIENT LEAFLET

This good-looking leaflet is easy to read and worth printing off, especially if you can do double-sided printing.

The result is two A4 pages with an excellent explanation of ITP that will prove useful for GPs to hand out to patients or parents of sufferers.

Perhaps somewhat ironically, after what I have just said, it recommends readers to visit the ITP Support Association for more detail.

Why go there: Excellent patient leaflet.
Downside: None.
Information from: Great Ormond Street Hospital for Children NHS Trust.
Address: www.ich.ucl.ac.uk/factsheets/families/F040177/itp_leaflet.pdf

- Dr Barnard is a former GP in Fareham, Hampshire

WEBSITE OF THE WEEK

No, this is not a giant sea cucumber, but an enlarged spleen as a consequence of idiopathic thrombocytopenic purpura (ITP). It's so impressive I had to share it with you. The rest of the site is worth looking at because splenomegaly has many causes.

Although the information about ITP is minimal, there cannot be many GPs who don't have at least a couple of patients on their lists who have had a splenectomy, and the last paragraph of this page reminds you of the antibiotic and immunisation advice you need to give them.

Why go there: Worth it for the image alone.
Downside: You won't learn much more about ITP.
Information from: Surgical specialist registrar, Mr Stephen Parker.
Address: www.surgical-tutor.org.uk/default-home.htm?system/vascular/spleen.htm~right

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