UAE Indian survives blood disorder after 18 days in ICU

Dubai: A 52-year-old Indian in the UAE has survived a rare blood disorder and recovered after 18 days in the ICU.
LalTelu Ram Harkesh was diagnosed with Thrombotic Thrombocytopenia Purpura (TTP), which usually affects 4-6 persons per million population.

According to Lifecare Hospital in the UAE’s Mussafah area, TTP is a life-threatening disorder in which the blood clots that form in the small blood vessels throughout the body can limit or block blood flow to the major organs.

This, in turn, can damage the organs like the brain, kidneys, and heart and prevent them from functioning correctly.

When Harkesh experienced abdominal pain, he first ignored it as it did not seriously affect his daily activities.

Five days later, he developed a mild fever and decided to seek medical help. Things took a serious turn when, after laboratory and radiology investigations, doctors diagnosed him with TTP.

“During the initial evaluation, he seemed to be suffering from acute pancreatitis. But he had low red blood cell and platelet counts that did not correlate with the preliminary diagnosis.

“The ADAMTS 13 test confirmed he had TTP, a rare disease that can be fatal if left untreated. This is the first case of TTP we are coming across in our hospital,” said Dr Ashraf Abdelrahman, HOD, Critical Care Services at Lifecare.

Dr Abdelrahman said that such patients require close monitoring as they are at high risk for altered conscious level, seizures, hemiplegia and multiorgan failure.

For a patient confirmed with TTP, the treatment itself can induce serious hemodynamic instability.
Dr Mathew Vadakoot, Specialist Gastroenterologist, said diagnosing TTP was the main challenge they faced.

TTP is a rare disease with very vague symptoms, and the confirmatory test is performed only in a few laboratories in the country.
The hospital shifted Harkesh to the ICU and formed a 12-member multi-disciplinary team of doctors to analyse his health condition and plan the next steps.

“Harkesh received a total of 10 sessions of TPE daily with almost 30 liters of plasma exchanged. He was also treated with steroids and monoclonal antibodies medications,” said Dr AbeeshPadmanabha Pillai, Specialist Nephrologist.