The most common form of vasculitis in adults over the age of 50 is giant cell arteritis (GCA), an inflammation of the blood vessels that primarily affects the head—especially the temples and scalp—but also arteries in other parts of the body, including the aorta. Early diagnosis is critical in GCA to prevent vision loss and other serious complications. But unfortunately, GCA, which causes multiple symptoms and can mimic other diseases, is difficult to correctly diagnose, and treat.
Rheumatologist Marcia Friedman, MD, is trying to change all that through her work as the director of Oregon Health & Science University’s (OHSU) Vasculitis Center in Portland, Oregon. Her primary area of research is in identifying new diagnostic tests for GCA. “Without treatment, [GCA] can lead to blindness, strokes, and death,” she said. “Treating this form of vasculitis requires long-term use of steroids, which have a lot of side effects. So, it is very important that we don’t miss cases and that we don’t overtreat.” Dr. Friedman is Assistant Professor of Medicine, Division of Arthritis and Rheumatic Diseases, School of Medicine, OHSU. She became director of the vasculitis center in 2018—the only vasculitis center in the Pacific Northwest.
Dr. Friedman’s role is to coordinate the care of its vasculitis patients with all of the other specialists. Most of the time, patients will meet first with the rheumatologist and will then be referred to other specialists as needed. Other times, patients are first seen by one of the specialists and then referred to the rheumatologist. “Since we opened, we have seen increasing demand for specialized multidisciplinary care,” Dr. Friedman said. “We hope to continue to expand to serve the needs of our patients.” Patients need a referral before they can be seen at the center.
“Vasculitides are multi-organ system diseases,” Dr. Friedman said. “The primary purpose of a vasculitis center is to have access to multiple specialists with expertise in vasculitis of various organ systems.” She said the clinic is lucky to have vasculitis experts in dermatology, ophthalmology, otolaryngology, nephrology, and pulmonology. All of the providers work collaboratively as a team to provide the best possible care.
Research also plays an important role at the OHSU Vasculitis Center. By partnering with organizations such as the Vasculitis Clinical Research Consortium, patients are offered opportunities to participate in OHSU, national, and international research studies, as well as in nonclinical trial research. Patients are often asked to donate blood and tissue samples, which are used to advance the clinic’s understanding of vasculitis.
“Vasculitis diagnosis and treatment can be challenging and we strongly believe that patients get better care from a team of doctors working together than they would from any one of us as an individual,” Dr. Friedman added. The ultimate goal of the center is to provide multidisciplinary care for patients with vasculitis, and advance vasculitis research leading to better diagnostic tests, and more effective, less toxic treatment.
Author: Nina Silberstein
This article originally appeared in the March/April 2020 VF Newsletter.
