Bank of America senior executive dies of dengue-related complications in Mumbai
Sanjeev Jha, 34, head of capital markets at Bank of America Merrill Lynch, died of hemophagocytic lymphohistiocytosis (HLH) at Lilavati Hospital in Bandra.mumbai Updated: Sep 08, 2017 16:53 IST
A senior executive of Bank of America died of a complication triggered by dengue in Mumbai, leading to a warning from specialists that doctors should study the immune system of patients suffering from the disease if the symptoms persist for 4-5 days.
Sanjeev Jha, 34, head of capital markets at Bank of America Merrill Lynch, died of hemophagocytic lymphohistiocytosis (HLH) at Lilavati Hospital in Bandra.
Dengue has led to six deaths in Mumbai this year.
HLH is a rapidly progressive, life-threatening syndrome of excessive immune activation which triggers excessive build-up of white blood cells in multiple organs of the body including neurological areas, affecting other blood cells.
Doctors said the rare immunity condition with high morbidity and mortality rate is triggered by dengue and other viral infections but can be diagnosed only after multiple tests.
“It’s sad that Jha had to die at such a young age, but HLH is an extremely specific diagnosis which need multiple opinions and specialists confirming it. The condition has high mortality and even higher morbidity if not diagnosed or treated specifically in time,” said infectious diseases expert Dr Om Srivastava.
Jha was admitted to Lilavati Hospital on August 29. He was diagnosed with HLH only on September 5, after multiple tests.
Doctors said the condition was specifically more virulent in case of Jha as it affected his kidneys and liver along with multi-organ involvement.
He died of HLH and dengue shock syndrome at the hospital on Tuesday.
Dr V Ravishankar, CEO of Lilavati hospital refused to comment when asked if the family had filed a case of negligence.
City doctors said that the immunological disorder is not as rare as it is believed to be by most physicians.
Dr Vasant Nagvekar, infectious disease specialist, said, “One can suspect HLH, when the fever caused by any viral or bacterial infection such as malaria, remains high, for over four to five days.”
In Jha’s case, his fever did not subside despite being treated with increasing doses of paracetamol. “In dengue, only the symptoms can be treated. While milder forms of HLH are common in dengue, in this case, the condition was far more severe,” he said.
Dr Tanu Singhal, consultant with Kokilaben Dhirubhai Ambani Hospital said, last year, seven patients suffered from HLH following dengue, of which six died after a prolonged course in the intensive care unit . This year too, she has seen two patients suffering from HLH, of which one has died. “The patient was 55 years old and didn’t survive even for 48 hours after he was diagnosed. The prognosis is quite scary in severe cases of HLH,” she said.
Dr Vatsal Kothari, director, critical care medicine at Kokilaben Dhiirubhai Ambani Hospital, said, “High levels of ferritin, is one indicator that the infection could have lead to HLH. We don’t rule out HLH, in cases where there are unexplained high levels of ferritin,” he said.
In Jha’s case too, HLH was confirmed when doctors checked for his ferritin and LDH (lactose dehydrogenase) enzyme levels, which were disproportionately high