Brianna’s Battle: saving sight with placentas

Imagine taking your normal prescription medication or even just ibuprofen and then watching your skin painfully peel off your body.

That is what happens to people with a mysterious disorder, but the condition threatens more than their skin.

Warning: images in the video for this story may be disturbing.

Patients look like burn victims, but reactions to prescription or over-the-counter medications is what causes it.

"Her skin peeled off,” said Gina parks whose daughter had Stevens-Johnson Syndrome. “It was horrible. I was scared."

"It is characterized by sloughing of the skin and the mucus membranes," said Amy Lin, MD, Assistant professor in the Department of Ophthalmology at Loyola University Medical Center.

Gina Parks' daughter Brianna got the potentially deadly condition after taking children's Tylenol.

"My mom told me I could go blind," said Brianna Thompson.

"It can lead to permanent scarring in the eyes and the eyelids, and that can lead to severe vision deficits and even blindness," said Dr. Lin.

But Dr. Lin said part of a human placenta, called the amniotic membrane, helped Brianna and others like her keep their sight.

The fetal tissue is full of anti-inflammatory and wound healing properties.

It is sutured on to the eyes and eyelids and within weeks, the membrane is absorbed into the eye, helping create a new surface.

As for Brianna, "You can barely tell anything even happened to her," said Dr. Lin.

Her eyes are just fine. Now, this natural shooter has her sights set on making her school's basketball team.

"Because I like being active," said Thompson.

Those who do not have the procedure are eight times more likely to have vision problems than patients who do have the surgery.

Dr. Lin said if the amniotic membrane transplant does not work the first time, it can be repeated. She said she has to repeat the surgery in about 25% of patients.

BACKGROUND: Stevens-Johnson syndrome is a rare, serious disorder in which your skin and mucous membranes react severely to a medication or infection. Often, Stevens-Johnson syndrome begins with flu-like symptoms, followed by a painful red or purplish rash that spreads and blisters, eventually causing the top layer of your skin to die and shed. Stevens-Johnson syndrome presents a medical emergency that usually requires hospitalization. (Source: Mayo Clinic)

SIGNS: Signs and symptoms of Stevens-Johnson syndrome include facial swelling, tongue swelling, hives, skin pain, a red or purple skin rash that spreads within hours to days, blisters on your skin and mucous membranes, especially in your mouth, nose and eyes, and shedding (sloughing) of your skin. If you have Stevens-Johnson syndrome, several days before the rash develops you may experience fever, sore throat, cough, or burning eyes. Stevens-Johnson syndrome requires immediate medical attention. Seek emergency medical care if you experience any of the following signs or symptoms: unexplained widespread skin pain, facial swelling, blisters on your skin and mucous membranes, hives, tongue swelling, a red or purple skin rash that spreads, or shedding of your skin. (Source: Mayo Clinic)

TREATMENT: Stevens-Johnson syndrome requires hospitalization, often in an intensive care unit or burn unit. The first and most important step in treating Stevens-Johnson syndrome is to discontinue any medications that may be causing it. Because it's difficult to determine exactly which drug may be causing the problem, your doctor may recommend that you stop taking all nonessential medications. Currently there are no standard recommendations for treating Stevens-Johnson syndrome. Supportive care you're likely to receive while hospitalized includes: fluid replacement and nutrition, wound care, and eye care. Medications commonly used in the treatment of Stevens-Johnson syndrome include: pain medication to reduce discomfort, antihistamines to relieve itching, antibiotics to control infection when needed, and topical steroids to reduce skin inflammation. In addition, you may receive one of the following types of medications that are currently being studied in the treatment of Stevens-Johnson syndrome: intravenous corticosteroids or immunoglobulin intravenous (IVIG). If a large area of your body is affected, skin grafting - removing skin from one area of your body and attaching it to another or using a synthetic skin substitute - may be necessary to help you heal. This treatment is only rarely required. If the underlying cause of Stevens-Johnson syndrome can be eliminated and the skin reaction stopped, your skin may begin to grow again within several days. In severe cases, full recovery may take several months. (Source: Mayo Clinic)

NEW TECHNOLOGY: Loyola researchers studied a relatively new eye treatment for SJS/TEN patients called amniotic membrane transplantation. Amniotic membrane is part of the fetal membranes that surround and protect the baby in the womb, and have natural therapeutic properties. When placed on the eye, amniotic membrane can help aid healing, decrease inflammation and minimize scarring. (Amniotic membrane is donated by a consenting mother following the birth of her baby.)

Previous studies have found that amniotic membrane transplantation is effective in the chronic stage. The Loyola case-control study is one of the largest studies to examine the effect of amniotic membrane transplantation in the early, acute stage. (Source: Sciencedaily)


Maggie Reeb
Loyola University Medical Center

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