Often, one of the greatest challenges a patient with vasculitis faces is receiving a definitive diagnosis. Patients often spend months or even years seeking a diagnosis or worse, living with a misdiagnosis and ineffective treatment.
The Vasculitis Foundation also recognizes that there are many health care professionals who have MADE the diagnosis of vasculitis, and we want to honor them for their efforts to care for our patients.
The idea for the V-RED Award originated with VF Board Member, Karen Hirsch, whose son, Michael, was diagnosed with GPA/Wegener’s in 2011 by Dr. Juanita Mora, an allergist/immunologist at the Chicago Allergy Center. ”I followed my gut and ordered further testing,” says Dr. Mora. “The labs and CT Chest confirmed the diagnosis of GPA/Wegener’s. Michael received prompt treatment, and the early diagnosis was critical and lifesaving in the preservation of his healthy organs and getting him in remission.”
It was a combination of frustration at pediatric experts missing her son’s disease, and the desire to recognize and reward those doctors who do make an early diagnosis of vasculitis, which led Karen to propose the VF V-RED Award. Hirsh developed the award to recognize and reward those health care providers who made an early diagnosis of vasculitis in a patient. Each year the Vasculitis Foundation solicits patients in the vasculitis community to nominate a doctor who made an early call on their diagnosis.
The 2019 V-RED Awardees
Two winners tied for first place and another received an honorable mention in the Vasculitis Foundation’s 2019 Recognizing Excellence in Diagnostics (V-RED) award program. With more nominations than ever before, the program, now in its 6th year, has grown into a powerful campaign that raises awareness about early diagnosis.
First Place Winner: Mark Anderson, MD
Nancy Anderson’s early, nonspecific symptoms lead to multiple visits with specialists who misdiagnosed the underlying condition. As her condition worsened, one doctor, in particular, was determined to get some answers—her husband, Mark Anderson, MD, who is board-certified in internal medicine and anesthesia in Maitland Florida. Fortunately, he had some knowledge of vasculitis from treating patients with giant cell arteritis (GCA), so he knew what lab tests needed to be ordered for Nancy.
First Place Winner: Gwendolyn Shelton, MD
Central Vermont Medical Center, Berlin, Vermont
In March 2008, during her freshman year in high school, Meaghan Carpenter began exhibiting peripheral neuropathy in her legs, in addition to chronic asthma and allergy issues that didn’t appear to have any common thread. Eventually, Carpenter’s pain grew worse, and she was admitted to the pediatric ward at Presbyterian Hospital in Albuquerque, New Mexico.
Fortunately, Gwendolyn (Lattimore) Shelton, MD, was a hospitalist on her medical team who felt Carpenter’s case needed more in-depth investigation. Dr. Shelton did extensive online research, and consultation with a rheumatologist to determine that Meaghan had eosinophilic granulomatosis with polyangiitis (EGPA).
With her diagnosis, the doctors at Presbyterian Hospital were able to begin treatment early enough to prevent her vasculitis from progressing and causing more systemic damage.
Honorable Mention: Andrew Lee, MD
Kent Town, South Australia, Australia
Carmen Haule Reaiche credits her early diagnosis to Andrew Lee, MD, a neurologist in Kent Town, South Australia. It began when Reaiche suffered a series of strokes in her early forties. While other doctors couldn’t identify the underlying reason for the strokes, Dr. Lee did further research. He ordered a series of tests that finally produced a diagnosis of cerebral vasculitis.
Reaiche is now enjoying a life free from harsh medications,and debilitating symptoms.
The 2018 V-RED Awardee: Linda Brady, MD
The 2018 V-RED Awardee is Dr. Linda Brady, a pediatrician with Old Harding Pediatric Associates, Vanderbilt University Medical Center/Monroe Carrell Jr. Children’s Hospital, Nashville, Tennessee. Dr. Brady was nominated by Lisa Crabb the mother of Chip, who was diagnosed with Granulomatosis with polyangiitis (GPA/formerly Wegener’s) in September 2017.
photo caption l-r: Trey (dad), Chip, Dr Brady and Lisa Crabb (mom)
The Vasculitis Foundation is also pleased to recognize these physicians for Honorable Mentions:
Samir Parikh, MD
Ohio State Wexner Medical Center – Nephrology, Columbus, Ohio
Dr. Samir Parikh was nominated by Sandy Nye, who was diagnosed with Microscopic polyangiitis in 2014 after being sick for more than five years with no definitive diagnosis. Dr. Parikh, a nephrologist, made the diagnosis in four weeks after performing a kidney biopsy and recognizing the symptoms of vasculitis.
photo caption: Sandy Nye and Dr. Samir Parikh
Daniel Watson, MD
Park Nicollet St. Louis Park Clinic, St. Louis Park, Minnesota
Dr. Daniel Watson was nominated by Nicole Shankey in recognition of his diagnosis of Granulomatosis with polyangiitis (GPA/formerly Wegener’s) after an emergency room visit. Dr. Watson, an otolaryngologist, suspected the rare autoimmune disease after seeing Nicole during the ER visit. He recommended a course of high-dose steroids instead of an emergency tracheotomy.
photo caption: Dr. Daniel Watson and Nicole Shankey
This year we had a record number of physicians nominated by their grateful patients. We are pleased to honor them:
Jeffrey A. Alper, MD
Karen Andrews, MD
Antoine Azar, MD
Steven Baker, MD
Radu Butan, MD
Jean Calhoun, MD
Brian Callaghan, MD
David Clark, MD
Emmanuel Cruz, MD
Katherine Dent, MD
Kirk C. Eddleman, MD
Glenn Ehresmann, MD
Ronald J. Falk, MD
Juan Fernandez, MD
Mark Getz, MD
Keith Goldstein, MD
Thomas Hahn, MD
Tracey Ikerd, MD
Peter Kent, MD
Jonathan Kiev, MD
Rob Lister, MD
Richard Mahon, MD
Christopher Mawn, MD
Phuong Nguyan, MD
Margaret A. Ogden, MD
Ina Rose Oppliger, MD
Jerry D. Peterie, MD, FACP
Robert L. Pincus, MD
Nathalie Roy, MD
Abbah Singh, MD
Marybeth Son, MD
Jason Springer, MD
Gigi Toma, MD
Yong Tsai, MD
Syeda Uzma, MD
VCU Department of Nephrology
Corey Walker, MD
Randall Williams, MD
2017 V-Red Awardee
Three selected for the 2016 VF V-RED Award
Seth Sullivan, MD, Clinical Educator/Hospitalist at Norwalk Hospital, Norwalk, Connecticut
David Tait, a resident of New Canaan, Connecticut, nominated Dr. Seth Sullivan for the VF’s 2016 V-RED Award believing that it was Dr. Sullivan’s early diagnosis of vasculitis that gave him a more positive health outcome. In 2014, after suffering a heart attack, Tait was taken to the Norwalk Hospital Emergency Department where he was placed under the care of Sullivan.
Dr. Sullivan said that as a hospitalist he reviews each patient’s prior medical history and test results. He becomes a clinical data detective looking at all of the patient’s medical records for diagnostic red flags. In David’s case, it was an unusually high eosinophil count that captured Sullivan’s attention. Based on his findings, Sullivan was able to diagnose Tait with eosinophilic granulomatosis with polyangiitis (EGPA /Churg-Strauss Syndrome), a rare autoimmune systemic vasculitis.
“It took me some time to gather and review all of David’s records, and we were stymied for a couple of days when some of his workups came back negative,” said Dr. Sullivan. “However, I nonetheless suspected Churg-Strauss, and I was able to uncover a series of case reports of patients with Churg-Strauss, which fit David’s clinical profile.”
It was Sullivan’s early diagnosis of vasculitis that prevented the disease from progressing and causing more serious organ damage. Tait was immediately treated with prednisone and Cytoxan, which are standard therapies for vasculitis patients.
“The award is of course very meaningful to me personally, and I appreciate the recognition from the Vasculitis Foundation and all of the great work it does to raise awareness of these treatable but difficult-to-diagnose diseases,” says Dr. Sullivan. “I hope that this award can serve to prompt clinicians to keep vasculitis in mind as they go about their busy day-to-day activities so that we can intervene appropriately for our patients.”
Kate Kinney, ACNP, Monroe Clinic Hospital, Monroe, Wisconsin
Kate Kinney, Monroe, Wisconsin, was nominated for the VF’s 2016 V-RED Award by her patient, Michael Gunderson, a resident of Davis, Illinois. Gunderson was suffering from chronic symptoms that included severe sinus infections, joint swelling, and fatigue. When the symptoms grew worse and didn’t respond to multiple courses of antibiotics, Gunderson went to Kinney who works as a hospitalist at the Monroe Clinic.
Kinney and her medical team analyzed Gunderson’s medical history to search out a possible underlying cause for the chronic symptoms. She got a clue from Gunderson, who told her that an ENT once suggested he might have vasculitis, a rare autoimmune condition whose symptoms can mimic other common illnesses. However, numerous specialists who saw Gunderson didn’t suspect anything unusual.
What Kinney ultimately discovered from a lung biopsy was that Gunderson’s condition was anything but ordinary. She confirmed that Gunderson did have a rare, and serious autoimmune condition called Granulomatosis with polyangiitis (GPA/Wegener’s) vasculitis. The disease affects the upper and lower respiratory system and frequently involves the kidneys, lungs, eyes, ears, throat, skin and other body organs.
Once Kinney made the diagnosis, doctors were able to begin the standard therapies to treat his vasculitis. Gunderson credits Kinney’s tenacity and team-centered approach to her work as a major factor for catching the rare disease before it could cause further damage to his health.
“We were grateful that someone finally made a diagnosis, and that I was going to start an aggressive treatment plan, and maybe, just maybe, get me well again,” says Gunderson. “Without the GPA diagnosis by Kate, I think I can safely say I wouldn’t be here.”
Jeffrey Raines, MD, Obstetric/Gynecology Department of Fairview Medical Group Fairview Medical Center, Maple Grove, Minnesota
It is not unusual that a medical specialist is one of the first doctors to see a patient suffering the early onset of vasculitis symptoms. This was the case for Jodi Resnac, who was under the care of Dr. Jeffrey Raines, a general obstetrician/gynecologist and supervisor for the Obstetric/Gynecology Department of Fairview Medical Group in Kingsman Arizona.
Dr. Raines explains that in his role as Jodi’s obstetrician he was responsible for her care and the eventual delivery of her baby. During a routine testing of her kidney function, Dr. Raines caught a red flag. Jodi was showing protein excretion in her urine (proteinuria) which isn’t necessarily unusual during pregnancy. However, in Jodi’s case, it was happening much earlier than normal.
Dr. Raines sensed that something else was going on. “She was also complaining of problems with her nose and a loss of the sense of smell. That is a very unusual complaint from a patient,” explains Dr. Raines. “I remembered from my training there was a particular named disease, Wegener’s granulomatosis, where you see nasal lesions in addition to a glomerulonephritis (inflammation of the kidney) that can cause proteinuria. There are several more common blood tests that we can do to evaluate for a rheumatologic condition and when these were positive, we then referred Jodi to Rheumatology, and also involved Maternal Fetal Medicine once the diagnosis was confirmed.”
Jodi remembers the appointment when she got the diagnosis started out normally, but turned serious as Dr. Raines shared his concern over her tests. “He sat me down and told me he had run some tests because he had seen an abnormal amount of protein spilling into my urine,” Jodi recalled. “I also tested positive for the ANCA test. He gently said he was suspicious that I had a treatable auto immune disease called Wegener’s granulomatosis.
Jodi immediately contacted her mother, Jan Petersen, with the news. It was particularly devastating to Jan because she was familiar with the disease. “When Jodi told me the news, I knew exactly what she was talking about because my sister had had a series of five collegian diseases from 1975 until her death in 1981. Wegener’s being one of them. When Jodi told me the name of the disease, I just put my head on my desk and tried not to cry,” Jan said.
Jodi began treatment for vasculitis with prednisone and methotrexate. Since her diagnosis in 2003, Jodi’s team of doctors grew as she dealt with complications from the vasculitis. Today, her creatine level is normal, and she hasn’t experienced any flares.
Jan learned about the V-RED Award and nominated Dr. Raines because she believes it was an early diagnosis that made all the difference for Jodi. “I nominated Dr. Raines for the V-Red Award because that is exactly what he did for her,” explained Jan. “He diagnosed Jodi early on and enabled her to get excellent medical care following the birth of our grandson.”