Introducing Dr. Larry Moreland and Dr. Kim Liang
June 2013:
The Pittsburgh Center for Vasculitis: Caring for Patients and Conducting Research
By Ed Becker
Since 2007, the University of Pittsburgh Division of Rheumatology and Clinical Immunology has consistently been named one of the top programs for rheumatology in the United States by U.S. News & World Report.
Dr. Larry Moreland, the chief of the division and co-director of the Pittsburgh Center for Vasculitis (a division of the Rheumatology Center) believes that it is a reputation that is well-earned.
Dr. Kim Liang serves as co-director of the Center for Vasculitis and together they are working to make the center a dedicated clinic for vasculitis patients and a fertile research environment for this disease. The center serves patients throughout southwestern Pennsylvania, as well as the tri-state region near Pittsburgh.
The Center for Vasculitis is one of five centers under the umbrella of the Division of Rheumatology, with the four others focusing on Lupus, Rheumatoid arthritis, Scleroderma, and Myositis.
Dr. Moreland came to the University of Pittsburgh in 2007. He completed his Rheumatology fellowship at University of Alabama (UAB) in 1990 and stayed on faculty at UAB until 2007.
“One of our primary goals here is to provide the best possible care for patients with vasculitis, and additionally to provide education and support for patients and their families,” said Moreland. “Vasculitis is both a rare and complex disease so it is critical that we provide our patients with clinical care and also help both the patient and medical community understand this disease.”
Another challenge presented by vasculitis is that it can affect numerous body systems requiring a team approach to patient care. Moreland explains, “Vasculitis patients may present with a multitude of symptoms, or have extensive organ involvement. Therefore, our approach is an interdisciplinary one—that is to say, we have kidney, lung, and brain specialists who are involved in the care of the vasculitis patient. Our goal is to get the patient into our system quickly, and to have communication with everyone.”
Dr. Liang says that patients come to the Center for Vasculitis from a variety of sources; however, one of the most common ways is that the patient is referred by his/her primary care physician (PCP) when the patient exhibits a number of non-specific symptoms such as weight loss, fever, fatigue/malaise, or elevated inflammatory markers in the blood.
“When a patient comes in for the initial office visit, they can expect a long office visit because we’ll be asking very thorough questions about their medical history,” explains Dr. Liang. “It is important we get a comprehensive overview and physical examination of the patient, a number of baseline tests that include blood work, imaging, and depending on the case, possibly tissue biopsies.”
Dr. Liang says that some patients may remain under the direct care of their PCP, and the Center for Vasculitis will work with that patient’s physician in a consultant role. “I do care for some patients through direct consultation and collaboration with their local physicians, especially if they live far away. We exchange medical records, discuss symptoms with their local doctor(s), and look closely for potential manifestations of a flare. In certain instances, we have facilitated the hospital-to-hospital transfer of the patient for more specialized care.”
While patient care is a crucial aspect of the Center, an equally relevant area is research into the disease. The University of Pittsburgh/ UPMC is one of only nine academic institutions in the United States and two in Canada given the distinction of Vasculitis Center by the Vasculitis Clinical Research Consortium, a member of the Rare Diseases Clinical Research Network which is funded by the National Institutes of Health.
“We have lots of cutting edge protocols where we are putting patients into the registries to look at long term natural history of these diseases,” says Dr. Moreland. “We also have innovative clinical trials with new drugs so that we can see if we can alter the natural history of some of these diseases.”
Dr. Liang adds, “I’m pretty passionate about rare disease research because these diseases are complex and there is a lot that we still need to learn about vasculitis. One of the areas that I’m focusing on is vascular complications of rheumatoid arthritis (RA), and the different roles of inflammation in the vascular disease seen in RA, compared to vasculitis. This is just one of the areas that we are studying right now.”
Ed Becker, VF Board member and founder/director of the PAN Support Network videotaped short interviews with Drs. Moreland and Kim. Watch the videos on the VF Education Channel:
- Dr. Liang talks about the collaborative approach to working with a patient’s PCP and coordinating the specialized care provided by the Pittsburgh Vasculitis Center. Click here to watch the video.
- Dr. Larry Moreland talks about the clinical, multi-disciplinary approach of the Pittsburgh Vasculitis Center and why it’s especially critical for vasculitis patients. Click here to watch the video.
