CSI MEDBLOG’S STAT OPINION BOX
Could Arafat have AIDS?
Best Explanation of his bizarre symptoms I’ve heard yet
Do I believe it?
65/35 would be my probability estimation of this being true
Nothing the press has reported about Arafat's illness has made much sense to me, as a physician.
He was sick for a long time, flulike maybe, then it got worse. He was having "stomach" pain (Note to the Press: can we start using the proper term abdomen please?). Then he fainted. At that point they decided it was bad enough to call 911 so they dialed up a gang of Egyptian doctors who ran right over and discovered a high white blood cell (WBC) count and a low platelet (PLT) count. Their advice? Let some one else take this case (in America it's called patient dumping). So they turfed the leader of the Palestinians to France.
Looking gaunt (some say he has lost 1/3rd his body weight), Arafat arrived via private jet in Paris and was shipped to the Hospital d'Instruction des Armees de Percy in France.
Now, this hospital does have some hematologists/oncologists who have published important papers and everyone seems to agree that the hospital has some reputation for treating nonsolid tumors (blood and lymph malignancies).
The Egyptian Docs, apparently, ascribed the high WBC and low PLTS to leukemia, thus the rush to subspecialize Arafat's treatment. Once in France, however, the high white cell count (it had to be pretty high, I guess, for them to think he had leukemia, like, over 20-30K) improved (think infection, everyone -- although an odd response if he has AIDS) and some "tests" excluded leukemia from the list of diagnostic possibilities. Hmmmmmm.......
They gave him a PLT transfusion, so you know his PLTS were pretty bad...you know, falling down around the 10K level...
Next I read a hospital statement that Arafat has "persistent abnormalities in indicators for digestive function."
Indicators for digestive function?
OK, I'll lay that off to translation. Are they talking liver function tests (LFTs)? Probably. Now follow me closely here....
The hospital then says that whole body CT scans were negative (so no biliary obstruction, no significant pancreatic / liver/ kidney/ adrenal masses; no big spleen; no lymphandenopathy) and they also report that Arafat does not have leukemia or cancer.
By this point everyone is thinking, well maybe it's just that his stomach really does hurt!
If Arafat does not have a tumor on CT, yet he has abnormal LFTs he probably has hepatocellular inflammation/infection (like Hepatitis B?). Low PLTs without a big spleen suggests immune destruction (autolysis) either as a single entity or in combination with another disease (favored), less likely drug interaction...in any event low platelets (thrombocytopenia) is common in HIV patients.
THE ELECTION COMA -- LOOK OUT EUROPE!
Then, just as Arafat seems to be doing better he watches the election results on Tuesday and then (like about 50 million Americans and all of Europe) immediately lapses into a coma (which would NOT have happened if John Kerry was elected -- so ALREADY the election of George Bush is paying off).
Okay, so let's put it together like this: he is HIV+ without adequate treatment (maybe undiagnosed), suffers inanition, Hepatitis B, ? +/- superinfection two weeks ago (choose a bug and a site) and now has encephalopathy either from viremia or from the failure of the exit polls predictions.
CSI MEDBLOG’S STAT OPINION BOX: EVIDENCE SUMMARY
- SUBACUTE-CHRONIC VIRAL-LIKE ILLNESS
- INANITION (? 1/3 OF BODY WEIGHT)
- ABNORMAL LFT'S WITH NEGATIVE CT SCAN (? HEPATITIS B)
- ? RECENT UNEXPLAINED INFECTION (HIGH WBC NOW REGRESSED)
- NO LIQUID OR SOLID TUMOR (WHOLE-BODY CT NEGATIVE LEUKEMIA WORK-UP NEGATIVE)
- THROMBOCYTOPENIA (COMMON AIDS-RELATED DISORDER
- PATIENT BEING TREATED AT A FACILITY KNOWN FOR ITS EXPERTISE IN HEMATOLOGY/ONCOLOGY -- A LOGICAL & USUAL PLACE TO REFER DIFFICULT HIV CASE ___________________________________________________
OKAY, BUT HOW DID ARAFAT GET INFECTED WITH HIV?
This has been kicking around the quiet corners of the Internet for a while, but recently it has gathered strength like a williwaw rising off the Dead Sea. Roger Simon (if you are not reading his Blog -- YOU LOSE) said that many had heard these speculations but Mr. Simon chose to be intelligently mum in the face of a dearth of empirical eviidence.
David Frum (another must read) folowed up with a blogastrophic piece in his 10/29/04 blog revealing some shocking charges made by Ion Pacepa, the former Romanian intelliegnce chief; namely:
Pacepa tells in his very interesting memoirs that the Ceaucescu regime taped Arafat's orgies with his body guards.
Various Israeli security sources have in the past suggested publicly Arafat might be homosexual. They've claimed Arafat's former personal driver – a Mossad double agent – used to find teenage boys to bring back to the PLO leader. His wife, Suha, mostly lived abroad and rarely saw her husband.
The medical evidence is not enough, obviously, to draw any definite conclusions; however, the revelations by Frum and others cast the entire confusing case in a partly rectifying new light and may also help to explain why there is so little coherent information and so much obfuscation from the Arab and French doctors -- I was beginning to think they might be grossly incompetent. Maybe they're just being coy.
...hat tip and thanks to Grace H. Boyle
Stay Tuned TO CSI MEDBLOGS