When she began her medical training in India at Maulana Azad Medical College, Ruchika Sharma, MD noticed an alarming reality: “I saw a population of patients that is very under-served,” she says. “Women and children with bleeding disorders weren’t receiving the treatment they receive in developed nations.”
Dr. Sharma came to one such developed nation - the United States - and completed her residency in pediatrics at the University of Toledo College of Medicine, followed by fellowship training at Nationwide Children’s Hospital. Now, she works at the Children’s Hospital of Wisconsin as a hematology specialist: “I’m responsible for taking care of children with coagulation disorders,” she explains, adding that, in particular, she treats adolescent girls with heavy menstrual bleeding at an outpatient clinic at the Children’s Hospital of Wisconsin.
But still - even in a developed nation like the U.S. - Sharma is witnessing a similar neglect of women and children. And so - armed with both her worldview AND a personal commitment to her own sex - she applied for and received our 2017 Foundation for Women and Girls with Blood Disorders research fellowship award for a project designed to “Examine coagulating disorders in menstruating adolescent females,” under the mentorship of Veronica Flood, MD.
“At this point, we are targeting a pilot project for 20 patients,” Sharma says. “The goal will be to have a multi-center study; and then the future direction is that we should have more specific diagnostic and treatment algorithms for patients with heavy menstrual bleeding and other bleeding disorders.”
Several bleeding disorders, such as von Willebrand disease and mild platelet function defects, are common in Sharma’s experience. She also treats hemophilia carriers. Knowing this prevalence and obtaining a good personal and family history, she says, are considerations providers should use when trying to diagnose a new patient.
Sharma contends that rare bleeding disorders - such as rare platelet function defects and disorders of fibrinolysis - can be diagnosed by genetic testing, but that genetic testing is not routinely performed. “There is emerging literature about certain genetic panels you can use for these patients to facilitate accurate diagnosis and utilize specific targeted therapies,” she says.
“We also do comprehensive functional testing to further diagnose the bleeding disorder.” Her hope is she can continue to evolve the diagnostic process for this globally under-served population of females, so treatment options can be selected more efficiently and more accurately.
Finding study participants has posed a challenge for the project in its first year and Sharma has received a no-cost extension with plans to complete her analysis in June of 2019. But she’s determined to streamline bleeding disorder diagnostics, for women here and abroad alike: “These diagnostic challenges are very interesting to me. There’s a lot of ‘figuring out’ that has to happen, but we can make this process easier and better for the patients.
“Being a woman myself, I feel this is a population that has not received the quality of care it should,” Dr. Sharma concludes. Her commitment to women’s health and hematology makes her an ideal research fellow for our “Bleeding Disorders Affecting Women and Girls” grant program.
We look forward to hearing some powerful results from this study in 2019!