Kam A. Newman, United States of America

Eisenhower Medical Center Rheumatology
Dr. Newman received his medical degree from Teheran University with honors, and completed his internship and residency in internal medicine in New York City/New York with top 10 percent score of the American Board of Internal Medicine (ABIM). Dr. Newman completed his first fellowship program at prestigious Cleveland Clinic, Ohio, and his second fellowship program at National Institutes of Health (NIH)/National Institute of Arthritis, Musculoskeletal and Skin Disease (NIAMS), home of 149 Nobel Laureates. During his tenure at NIH/NIAMS, Dr. Newman had oral presentation on CD73 deficiency at the American College of Rheumatology (ACR) meeting, and publication on using PET scan in large vessel vasculitis as first author at the Arthritis and Rheumatology (ANR), official journal of the ACR. Most recently, Dr. Newman joined Eisenhower Health, a world-class institution named as one of the top one hundred hospitals in the United States. He uses the cutting edge science of musculoskeletal ultrasound (MSKUS), and color Doppler to produce pictures of muscles, tendons, ligaments and joints throughout the body to help diagnose of sprains, strains, tears and other soft tissue conditions for both diagnostic and therapeutic purposes. With ultrasound-guided local steroid injection, Dr. Newman effectively treats carpal tunnel syndrome (CTS). Dr. Newman has published several peer-reviewed articles, and books in rheumatoid arthritis (RA), large vessel vasculitis, systemic lupus erythematosus, Sjögren's syndrome, autoimmune neuropathy, cancer-related autoimmune disorders, other autoimmune disorders such as autoimmune neutropenia, gene therapy, and medical ethics among others. Dr. Newman is an official member of the American College of Physicians (ACP) and the American College of Rheumatology, and he serves as both ABIM and the American Board of Medical Specialties (ABMS) Diplomat. He is a clinical assistant professor at the University of California, Riverside (UCR), School of Medicine.

Presenter of 1 Presentation

 Conference Calendar

SJÖGREN SYNDROME: AN UNDIAGNOSED ETIOLOGY FOR FACIAL PAIN: CASE SERIES WITH REVIEW OF NEUROLOGICAL MANIFESTATION OF SJÖGREN SYNDROME

Session Name
PS21 -CNS AND AUTOIMMUNITY
Session Type
PARALLEL SESSIONS
Date
30.05.2021, Sunday
Session Time
10:00 - 12:00
Room
HALL C
Lecture Time
11:40 - 11:50
Presenter
Session Icon
Pre Recorded

Abstract

Background and Aims

Facial pain is a challenging entity in medicine, and has a wide range of differential diagnoses. Therefore, different disciplines including neurology, otolaryngology, pain medicine, dentistry and neurosurgery may be involved in diagnosis and management of these individuals although rheumatologic etiology of facial pain has been less discussed and recognized.

Methods

In this case series, we catalogued eleven facial pain patients: 7 were diagnosed with trigeminal neuralgia, 3 with atypical facial pain, and 1 with persistent idiopathic facial pain. All patients were evaluated by several specialists including neurologists, dentists, endodontists, otolaryngologists, pain specialists and neurosurgeons. Two patients underwent craniotomy for microvascular decompression with diagnosis of trigeminal neuralgia with no relief.

Results

All patients were female with negative Sjögren’s syndrome antibody but proven by salivary gland biopsy. All but one were positive for ANA. ESR was normal in all patients, but CRP was elevated in three patients. Brain and trigeminal nerve MRI were unremarkable in all patients. Minor salivary gland biopsy confirmed lymphocytic sialadenitis. Lymphocytic sialadenitis is considered histologic hallmark of Sjögren’s syndrome. Lymphocytic sialadenitis is characterized by presence of significant perivascular or periductular lymphocytic infiltrate. All patients but one complained of sicca syndrome. Age of onset for facial pain in all patients except one was before 50.

Conclusions

CNS and cranial nerves involvement, particularly trigeminal nerve involvement that may present with facial pain or headaches, as the main pSS presenting manifestation has been underestimated and under-looked. We recommend painful trigeminal neuropathy secondary to pSS should be considered in differential diagnosis of facial pain particularly in patients who carry PIFP diagnosis.

Hide