Recurrent respiratory papillomatosis: A case of persistent stridor in an 18-month-old child

  • Kelsie Ovenell, OMS-IV Midwestern University Arizona College of Osteopathic Medicine
  • Binh Phung, DO, MHA Oklahoma State University Center for Health Sciences College of Osteopathic Medicine, Department of Pediatrics
  • Sister Mary Rafqa Boulous, DO Oklahoma State University Center for Health Sciences, Department of Pediatrics
  • DanThuy N Doa, DO Midwestern University Arizona College of Osteopathic Medicine, Department of Pediatrics
Keywords: Recurrent respiratory papillomatosis (RRP), human papillomavirus (HPV), laryngeal papillomatosis

Abstract


Recurrent respiratory papillomatosis (RRP) is characterized by non-cancerous verrucous, polypoid, wart-like growths occurring at the junctions of the squamous respiratory and ciliary epithelium, particularly the larynx. It is thought to be caused by acquisition of human papilloma virus (HPV) during pregnancy or passage through the birth canal of an infected mother. This case report describes an 18-month-old female who presented to the emergency department due to persistence of biphasic stridor unrelieved with dexamethasone and racemic epinephrine nebulized treatments. Pediatric otorhinolaryngologist performed laryngoscopy, which revealed bilateral papillomatous lesions of the larynx causing airway obstruction.

References

Kashima H, Mounts P, Leventhal B, Hruban RH. Sites of predilection in recurrent respiratory papillomatosis. Ann Otol Rhinol Laryngol 1993;102:580-583.

Larson DA, Derkay CS. Epidemiology of recurrent respiratory papillomatosis. AP MIS 2010;118:450-454.

Shah KV, Stern WF, Shah FK, et al. Risk factors for juvenile onset recurrent respiratory papillomatosis. Pediatr Infec Dis J 1998;17:372.

Wangu Z, and Hsu K. Impact of HPV vaccination on anogenital warts and respiratory papillomatosis. Human Vaccines & Immunotherapeutics 2016;12(6):1357-1362.

Silverberg MJ, Thorsen P, Lindeberg H, et al. Condyloma in pregnancy is strongly predictive of juvenile-onset recurrent respiratory papillomatosis. Obstet Gynecol 2003;101:645.

Shah KV, Stern WF, Shah FK, et al. Risk factors for juvenile onset recurrent respiratory papillomatosis. Pediatr Infec Dis J 1998;17:372.

Balazic J, Masera A, Poljak M. Sudden death caused by laryngeal papillomatosis. Acta Otolaryngol Suppl 1997;527:111-113.

Ahmed PA, Ulonnam CC, Undie NB. Recurrent respiratory papillomatosis: a report of two cases and review of literature. Niger J Ped 2014;41(1):7-73.

Hager WD. Human papilloma virus infection and prevention in the adolescent population. Journal Pediatric Adolescent Gynecology 2009;22:197.

Freed GL, Derkay CS. Prevention of recurrent respiratory papillomatosis: role of HPV vaccination. International Journal of pediatric otorhinolaryngology 2006;70:1779-1803.

Derkay CS, Wiatrak B. Recurrent respiratory papillomatosis: a review. The Laryngoscope. The American Laryngological, Rhinological and Otological Society, Inc. 2008;118:1236-1247.

Harman EM, Mosenifar Z, Sarma S, et al. Recurrent respiratory papillomatosis. Medscape reference. 2011. Web link: emedicine.medscape.com/article/302648.

Quin FB, Ryan MW, et al. Recurrent respiratory papillomatosis. Grand round presentation at UTMB, department of otolaryngology. 2003. Web link: www.utmb.edu.otoref/grnds/papillomatosis-2003-0265/papillomatosis2003-0625.htm.

Tasca RA, Clarke RW. Recurrent respiratory papillomatosis. Archives of Disease in Childhood 2006;91(8):689–691.

Sly PD, Collins RA. Physiological basis of respiratory signs and symptoms. Pediatric Respiratory Review 2006;7:84.

Izadi F, Hamkar R, Ghanbari H, Abdolmotallebi F, Jahandideh H. The role of human papilloma virus (HPV) genotyping in recurrent respiratory papillomatosis in Rasoul Akram Hospital. Med J Islam Repub Iran 2012;26(2):90-93.

Carifi M, Napolitano D, Morandi M, & Dall’Olio D. Recurrent respiratory papillomatosis: current and future perspectives. Therapeutics and Clinical Risk Management 2015;11:731-738.

Fusconi M, Grasso M, Greco A, Gallo A, et al. Recurrent respiratory papillomatosis by HPV: review of the literature and update on the use of cidofovir. Acta Otorhinolaryngologica Ital 2014;34(6):375–381.

Rogers DJ, Ojha S, Maurer R, Hartnick CJ. Use of Adjuvant Intralesional Bevacizumab for Aggressive Respiratory Papillomatosis in Children. JAMA Otolaryngol Head Neck Surg. 2013;139(5):496-501.

Katsenos S, Berker HD. Recurrent respiratory papillomatosis: a rare chronic disease, difficult to treat with potential to lung cancer transformation: apropos of two cases and brief literature review. Case Rep Oncol 2011;4(1):162-171.

Sullivan C, Curtis S, & Mouzakes J. Therapeutic use of the HPV vaccine in Recurrent Respiratory Papillomatosis: A case report. International Journal of Pediatric Otorhinolaryngology 2017;93:103-106.

Baumanis MM, & Elmaraghy CA. Intersurgical interval increased with use of quadrivalent human papillomavirus vaccine (Gardasil) in a pediatric patient with recurrent respiratory papillomatosis: A case report. International Journal of Pediatric Otorhinolaryngology. 2016;91:166-169.

Centers for Disease Control and Prevention (CDC) FDA licensure of bivalent human papillomavirus vaccine (HPV2, Cervarix) for use in females and updated HPV vaccination recommendations from the Advisory Committee on Immunization Practices (ACIP) MMWR Morb Mortal Wkly Report 2010;59:626.

Wangu Z, Hsu KK. Impact of HPV vaccination on anogenital warts and respiratory papillomatosis. Hum Vaccin Immunother 2016;12(6):1357–1362.

Published
2019-04-17
Section
Medical