Palestinian Girl Treated at Israeli Hospital for Rare Disorder

A Palestinian girl from Nablus with a rare medical condition underwent lifesaving surgery at Rambam hospital in Haifa last week, The Jerusalem Post reported on Sunday.

Jummana, 17, suffered from hypophosphatemia, a dangerous condition caused by low phosphate levels that led to extreme pain in her bones. Her treatment was facilitated by the United States National Institutes of Health (NIH), the Palestinian Authority, and Rambam hospital through the program “Bring the Patient, Bring the Surgeon,” which allows physicians from the West Bank or Gaza to join Palestinian patients who receive medical treatment in Israel.

Prof. Dov Tiosano, an Israeli pediatric endocrinologist, understood that Jummana’s condition was related to a newly discovered hormone called FGF23. An over-secretion of the hormone was identified as the source of the girl’s ailment. While initially it was believed that the hormonal problem was genetic, as her parents are first cousins, this was later ruled out by testing and a small tumor was discovered in the roof of her mouth. The tumor, which was “consuming massive amounts of calcium and phosphorous from Jummana’s bones,” was called rare for adults and “virtually unheard of” in a teen.

Following the diagnosis, the NIH contacted Prof. John A. van Aalst, director of the plastic surgery division at Cincinnati Children’s Hospital, to recommend the best hospital for the operation. Van Aalst recommended Rambam because Jummana’s endocrine examinations had been performed there, and since he had a good working relationship with Dr. Omri Emodi, the deputy director of Rambam’s oral and maxillofacial surgery department. “Because of all the connections here, it was simpler for the family, and in the end safest, because she had a major endocrine problem that would be quite complicated to treat once the tumor was removed,” said Dr. van Aalst.

After Jummana’s doctors referred her to Rambam through the PA’s health ministry, Dr. Emodi set up the preparations for the surgery. Jummana’s doctors from Nablus sat in on the procedure so that they would be prepared for her follow-up care. The arrangement was made possible by van Aalst, who had developed close ties with Jummana’s doctors and Emodi. “Every six months, I have been going to the West Bank and Gaza to operate,” Van Aalst explained. “At the end of my time there, I visit Rambam to work with Omri. Three years ago I introduced the surgeons from the PA to Omri; this is now their third trip here to Rambam.”

With the tumor gone, “we hope to be able to restore the calcium and the phosphate to her bones,” Tiosano said.

“Jummana will soon be released home to Nablus,” wrote Rambam’s health care campus spokesperson. “She still must undergo follow-up at Rambam for her ongoing condition, but her hope for the future is much brighter due to the collaboration and good will of doctors who live and breathe their Hippocratic oath.”

A video with Drs. van Aalst and Emodi describing the collaboration that led to Jummana’s treatment is embedded below.

[Photo: Rambam HCC / YouTube ]