Dr. Li's Quick Consultation with Dr. Lee Uncovered a Rare Case of MPA

July 9, 2024

Dr. David Lee (right), Mrs. Holder (middle) and Dr. Chang (left) Linda Holder thought she was recovering from COVID and didn’t think much of her symptoms of extreme exhaustion. However, when she started coughing up blood, she knew something more serious was happening. Dr. Xian Li was the Emergency Room doctor at Temecula Valley Hospital (TVH) that day and was the first to suspect that Mrs. Holder was suffering from a lung hemorrhage.

Dr. Li consulted Dr. David Lee, Pulmonologist and Program Director of Pulmonology Fellowship at TVH. Dr. Lee recalls the case clearly, “Dr. Xian Li was very astute and raised the possibility of the rare alveolar hemorrhage syndrome and he consulted me right away and I confirmed his suspicion,” explains Dr. Lee.

They sprang into action and treated her with high flow oxygen, antibiotics and blood transfusions. Further testing by Dr. Li and Dr. David Chang, a Nephrologist at TVH, ruled out rare infections and identified the disease as microscopic polyangiitis (MPA), an autoimmune disease and form of vasculitis—a family of rare disorders characterized by inflammation of the blood vessels, which can restrict blood flow and damage vital organs.

Dr. Lee is glad they caught it early. “She was facing multi-organ failure due to the aggressiveness of this immune system dysfunction that was attacking her own vital organs.” Mrs. Holder is glad for the team’s efforts. “It was a miracle that they figured it out, it is a very rare condition. The doctors worked so hard,” she says.

Note of appreciation for the staff

Mrs. Holder's appreciation for her health providers was demonstrated in the note she left at the time of her discharge, pictured here.

Note from Mrs. Holder showing her appreciation for the hospital staff

Dr. Lee agrees that working as a team was critical. “The collaboration among physicians in this case was special and key to her success, without any long term permanent vital organ damage. Dr. Chang helped me confirm it was MPA and start her care plan,” he says.

As Mrs. Holder’s treatment went on, she noticed the quality of care from the entire staff. “The nursing staff was great. They were always informative, always very responsive, very helpful. Whether they were a nurse, doctor, housekeeping, they were all wonderful. It is a great hospital,” she says. “Everyone was so kind and positive. They kept me uplifted. They never showed any negativity, which was important. I felt their positive energy and it made me fight for myself.” 

Mrs. Holder’s experience and diagnosis of MPA has taught her the connectivity of health in different areas of the body. As a result, she experienced the importance of a strong medical team that kept her condition and symptoms under control. “Their work as a team saved my life, and I am so grateful,” she says.