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Johns Hopkins

Johns Hopkins Pediatric

Managing Lipid Disorders

July 9, 2014

Since age 2, college student Megan Gwozdecke has traveled from New Jersey to Johns Hopkins for treatment of familial hypercholesterolemia. 

Peter Kwiterovich, MD

Lipid expert Peter Kwiterovich has taken care of three generations of families over 40 years. 

Megan Gwozdecke has a hard time remembering her first visit to pediatrician Peter Kwiterovich. After all, that visit occurred two decades ago. But her mother, Patty Gwozdecke, remembers the visit and the events leading up to it like they were yesterday—especially their pediatrician informing her that Megan’s total cholesterol was over 700, and that she had an extremely rare condition called familial hypercholesterolemia (FH), marked by abnormally high levels of cholesterol in the blood. Those born with it develop early onset fatty buildup inside the arteries that renders them stiff and hardened, which compromises blood flow and makes them vulnerable to heart disease very early in life.

“It was a rough time, to think your child might have a heart attack at age 10,” Patty Gwozdecke says.

The pediatrician referred Megan to a regional children’s hospital near their home in Moonachie, New Jersey, but over the course of a year pediatric cardiologists there could not significantly lower Megan’s cholesterol numbers.

“They said ‘this is beyond our expertise, you need to see this specialist at Johns Hopkins, one of the top guys on the East Coast for lipid disorders,’” says Patty Gwozdecke.

Kwiterovich, the Gwozdeckes learned, was indeed considered by many a pioneer in the field of lipid research and treatment, leading many of the early studies of children and adults diagnosed with FH. Among his findings was the identification of a pair of proteins that—like high density lipoprotein and low density lipoprotein (LDL)— may accurately predict coronary artery disease. Also, Kwiterovich was a principal investigator in the Triad Heart Study, which showed that the predisposition to develop LDL is often inherited. Attracting some 2,000 pediatric and adult patients from near and far, Kwiterovich’s clinic provided other investigators a unique opportunity to collect and compare biochemical and genetic data among multiple generations.

“He really started off this idea about identifying abnormal lipids not only in kids but through a family approach because it’s an inherited disease,” says cardiovascular nurse practitioner Kathy Byrne.

The Gwozdeckes were surprised to find Kwiterovich’s staff serving breakfast to whole families in the clinic, reflecting his holistic cradle-to-grave approach for treating lipid disorders. Thorough family screening, novel drug therapies, diet and exercise were pillars of treatment, as was a transparent connection with patients.

“In taking care of three generations of families over 40 years, Dr. Kwiterovich has never been shy about telling patients and their families why they may have an increased risk for heart disease and calling them out when they were not adhering to their prescribed therapies,” says Byrne.

Initially, Megan visited the clinic every three months for a cardiovascular checkup, physical exam, laboratory evaluation of her lipids, kidney and liver function tests, and exercise and nutrition counseling. Within a year her cholesterol and triglycerides reached manageable levels. Now she visits the clinic twice yearly. This past May she graduated from Kean University in New Jersey. Future plans include nursing school.

“She wants to help patients like herself,” says Byrne.

Although Kwiterovich has retired, the Wednesday clinic remains fully operational. “There are not a lot of centers with a specialized lipid program,” says pediatric cardiologist Shetarra Walker, “so it’s important that the clinic continues.” 

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