Indian resident recovers from rare blood disorder that can be fatal

LalTelu Ram Harkesh spent two weeks in intensive care in Abu Dhabi with condition that affects three in a million

Lead doctors in the medical team that treated LalTelu Ram Harkesh. Photo: Lifecare hospital

An Indian resident has survived a rare life-threatening disorder that affects three to four people per million.

LalTelu Ram Harkesh, 52, recovered from thrombotic thrombocytopenia purpura, or TTP, after spending more than two weeks in an intensive care unit at Lifecare Hospital in Abu Dhabi.

TTP is a life-threatening disorder in which clots form in the small blood vessels throughout the body.

These clots can limit or block blood flow to the major organs and damage parts such as the brain, kidneys and heart, preventing them from functioning properly.

Initially, Mr Harkesh, a foreman, felt abdominal pains that he ignored. He only sought medical help after developing a low-grade fever.

All thanks to the Almighty and doctors. This is my second life

LalTelu Ram Harkesh

Laboratory tests carried out at Lifecare Hospital later showed that he had 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,” said Dr Ashraf Abdelrahman, department head of critical services at the hospital.

Because of the low number of cases, TTP is difficult to diagnose and requires close monitoring as patients can develop seizures and multiple organ failure, among other complications.

The hospital immediately moved Mr Harkesh to the ICU and started therapeutic plasma exchange (TPE) — a process using plasma obtained from healthy individuals.

“Mr Harkesh received a total of 10 sessions of TPE daily with almost 30 litres of plasma exchanged. He was also treated with steroids and monoclonal antibodies medications,” said Dr A Pillai, a specialist nephrologist.

A 12-member medical team assisted with the procedure.

Mr Harkesh was sedated and placed on a mechanical ventilator to stabilise his condition.

It took about 18 days for the foreman from India’s Himachal Pradesh, to recover.

He had been in pain for about 20 days, before the procedure.

"I thought it was typical gas trouble," Mr Harkesh said. "But later, I found that I had a rare disease and I became scared.

"The doctors and other hospital staff supported me mentally and physically. All thanks to the Almighty and the doctors. This is my second life.”

Mr Harkesh was discharged last month on May 25. He is at home in India at present.

Dr Mudhasir Ahmed, a specialist oncologist said, as he has completely recovered from the initial attack, Mr Harkesh should have a normal quality of life in the future.

“Since relapse can occur at any time, he should do regular follow-up with the doctor and continue the treatment as recommended,” Dr Ahmed said.

"Most patients will have a complete recovery, but the literature says the relapse can occur in 30 per cent of patients,”

Early detection and treatment of these flare-ups are crucial in preventing irreversible damage to vital organs and death.

Dr Baiju Faizal, an internal medicine specialist, was also part of the team that attended to Mr Harkesh.

“What we know about TTP is that it is a true medical emergency, and without treatment, 95 per cent of patients succumb to death," said Dr Faizal.

"However, 80-90 per cent can achieve remission with treatment.”

TTP may relapse and cannot be prevented.

Doctors say when a patient has the disease diagnosed, it is advisable to follow a healthy lifestyle.