A leading University College Hospital and Harley Street consultant cardiothoracic surgeon, and haematologists at Guy’s and St Thomas’ Hospital have hinted that former prime minister Nawaz Sharif’s toxicology screening for poisoning will be ordered in London if no cause or cure is found of his unstable platelet count.
In a report submitted before the Lahore High Court (LHC), Dr David R Lawrence has written: “If the platelet count does not respond, he may be considered for possible toxicology screen. We want to target a platelet count between 50-150 to allow safe treatment with anti-platelet therapy.”
Hussain Nawaz, the former prime minister’s eldest son, raised alarm while his father was in Pakistan that the family suspected that Sharif may have been poisoned while in the custody of National Accountability Bureau (NAB).
Speaking to media in London last week, he stressed that the family did not blame anyone, but said that doctors were worried about the platelet count issue, and especially the fact that Sharif’s platelet count fell sharply and radically from over 75,000 to just about 2,000 within 24 hours while he was in custody.
Dr Lawrence has told the court that he examined Sharif, 69, in his clinic in London.
He wrote: “He (Nawaz Sharif) suffers from various significant ailments and comorbidities. He has been reviewed by the haematology team at the Guy’s and St Thomas’ Hospital and London Bridge Hospital, and has most likely ITP, the trigger and underlying cause for which is unclear, but he is having a slow response to first and second line therapies.”
ITP (Immune thrombocytopenic purpura) is a bleeding disorder in which the immune system destroys platelets.
In his report, Dr Lawrence told the court that there has also been a “recent exacerbation of coronary artery disease” and “there is ongoing persistent lymphadenopathy and bilateral carotid artery stenosis”.
The report adds: “A PET (positron-emission tomography) scan was arranged at London Bridge Hospital under Haematology at London Bridge, he has to be investigated for his lymphadenopathy; a lymph node biopsy has been recommended to him after the scan.
“He initially did very well following his coronary artery bypass surgery, but has had a troublesome circumflex vessel which has occluded on at least two occasions.
“The resultant effect has been persistent ischaemia in the lateral wall of his heart and NSTEMI.”
The report adds that Dr Chris Baker performed an angioplasty to this on October 9, 2017 but his symptoms are now recurrent.
The report says: “Cardiac MRI (magnetic resonance imaging) is booked via Chris Baker’s office. The team at the London Bridge have also arranged that he (Sharif) see Professor Simon Redwood, who I understand is going to repeat his coronary angiogram as a query proceed.
“Sharif is also due for a vascular referral to address the critical carotid artery stenosis (80% Rt ICA, October 2019) which is a risk for stroke.
“He has to proceed with cardiac and carotid issues once he stabilises and gets clearance from the haematology team treating him.
“I will look to review him with the results of his cardiac scans/cath and clinical hematology consults.”
The report adds that Sharif will have to find time for “short walks at least twice daily”.
“Sharif is currently undergoing investigations and is under constant clinical monitoring of the ongoing treatment which is paramount to stabilise his health, also requiring persistent follow-up in the United Kingdom until these issues are finally addressed and he is able to resume day to day activity”.
The report gives a full history of the former prime minister’s medical conditions, including recent major issues till now.
It also gives details of the kind of medication he is using.
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