Introducing Dr. Tanaz Kermani
For as long as she can remember, Tanaz Kermani was drawn to the medical field. “The ability to positively impact people’s lives and my love for biology were the primary factors that influenced my decision to pursue this career,” she says. The Mumbai native moved to the U.S. for undergraduate college and received her medical degree from the New York Medical College in Valhalla, NY.
Kermani, an assistant professor of medicine at the Mayo Clinic, specializes in rheumatology. “During my training, I was struck by the multi-system nature of these illnesses and the damage they could cause,” she says. “Rheumatology has always been regarded as one of the ‘cognitive’ specialties, requiring strong knowledge of general medicine and clinical skills. I quickly realized rheumatology would be the most rewarding and gratifying field of medicine for me and have never regretted this decision.”
After a rheumatology fellowship, Kermani is now doing the Vasculitis Clinical Research Consortium Fellowship at the Mayo Clinic. “My interest in vasculitis began during my fellowship program when I spent a few half-days working with Dr. Kenneth Warrington in our Vascular Center,” she recalls. “When I became aware of the Vasculitis Clinical Research Consortium [VCRC] fellowship which would enable me to dedicate two years to learning more about vasculitis, I was excited to pursue it.”
Her goals for the fellowship are two-fold: to gain expertise in the care of patients with vasculitis and to develop additional skills in clinical research. “The ability to focus my attention for two years only on vasculitis is invaluable,” she asserts. “Being part of the VCRC has also enabled me to interact with experts in the field at other medical centers. The clinical and research experiences I have gained thus far are unparalleled and would not have been possible without such a resource.”
As a VCRC fellow, she participates in all ongoing studies. She is currently working with Dr. Steven Ytterberg, Dr. Ulrich Specks and Dr. Kenneth Warrington at Mayo Clinic in the longitudinal studies of patients with different forms of vasculitis; and is involved in an ongoing clinical trial in Takayasu’s arteritis and giant cell arteritis (GCA). The latter disease is her primary research interest.
“Specifically, I am interested in the clinical course of the subset of giant cell arteritis patients who develop the disease in the aorta and its branches,” she says. “There are many aspects of GCA which make it a fascinating disease to study. First, it almost never affects younger individuals. As with many other autoimmune diseases, it affects women more than men. Additionally, the highest incidences are reported for Scandinavian countries and in US populations of Northern European ancestry. Many aspects of this disease remain poorly understood such as who develops complications, which patients have difficulty discontinuing their medications and how best to monitor GCA patients for aortic complications. These and other clinical questions are the focus of our research.”
Kermani knows that finding better treatments depends on support from advocacy groups like the VF. “Vasculitis advocacy groups are important and can assist patients…through education and moral support,” she says. “Patients with vasculitis and other rare diseases can feel isolated. Knowing that there are other people with the same condition and having the opportunity to share these experiences can be reassuring. From the physician’s standpoint, advocacy groups may be better able to reach out to our patients. They can inform them of the location and different types of research studies that may be of interest to them. This helps us engage our patients in research. Advocacy groups also provide a voice for their members and can communicate to us what we can do better to support and help our patients. The best way physicians and advocacy groups can work together is through collaboration and mutual respect.”
Editor’s note: Since we profiled her last year, Dr. Tanaz Kermani has completed her vasculitis fellowship program through the Vasculitis Clinical Research Consortium (VCRC). She has relocated from the Mayo Clinic to UCLA. She is building her clinical practice there and hopes to embark on research projects in the future. In the meantime, she remains involved in the projects she started with her mentors at Mayo and the VCRC.
I joined the faculty in the Division of Rheumatology at UCLA in February 2012. In general, there is still an unmet need for centers with expertise in vasculitis on the West Coast. This was a great opportunity for me to bring my experiences from my previous training at Mayo Clinic and the two-year fellowship with the VCRC.
As a clinician-educator, I enjoy spending my time in patient care and educating physicians-in-training. Whenever I mention my interest in vasculitis, our residents and fellows are intrigued and start asking questions. Educating them on how to recognize, evaluate and treat a patient with vasculitis is important and rewarding. I also have opportunities to raise awareness about vasculitis to the non-medical community via health talks sponsored by UCLA.
My current focus is to build a practice in rheumatology with an emphasis in vasculitis. Being part of an outstanding academic center like UCLA means that patients have access to an integrated approach with multiple specialists who are adept at caring for people with complex conditions.
Through my work at Mayo Clinic, I have developed an interest in large-artery complications like stenosis (narrowing of arteries) or aneurysms (ballooning of arteries) which can occur in patients with giant cell arteritis (GCA). We still don’t understand why only some patients with GCA develop these complications. We recently found that aortic complications have important prognostic implications for patients with GCA. Most experts agree that patients with GCA should be evaluated for complications, but we are still working on what is the best way to do this. Imaging (CT and MR scans) of the large vessels has been an area of active research and in the last decade. In fact, through these imaging studies, we’ve realized that the vasculitis in GCA affects multiple large arteries that may not be symptomatic but the clinical significance of this finding is not completely understood. We also clearly need better treatment alternatives for our patients with GCA. At present, prednisone and other “steroids” are the mainstay of treatment but have a lot of side-effects. With the research on mechanisms of inflammation in GCA and the availability of new medications targeting certain molecules (cytokines) in rheumatology, we are hopefully closer to finding new treatment options.