International Journal of Pediatric Otorhinolaryngology
Case ReportRecurrent laryngeal papillomatosis with oesophageal involvement in a 2 year old boy: Successful treatment with the quadrivalent human papillomatosis vaccine
Introduction
Recurrent respiratory papillomatosis (RRP) is a relentless, relatively rare disease of viral origin in which squamous papillomas frequently obstruct the respiratory tract of children and young adults, necessitating emergency interventions. Although many therapeutic modalities have been administered, so far no therapy has been proved to be curative for this process. Our case report proposes a completely novel therapeutic approach: immunization. The basic idea of this method is, that HPV infection itself can cause a local disease in the mucous epithelium and not evoke a general immune response. On the contrary, immunization with good host capability produces effective humoral and cellular response against the causative agents.
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Clinical history prior to immunization with the quadrivalent HPV vaccine
Our patient, a 2 and a half year old, otherwise healthy boy (born 1st June 2010) was first admitted to the Intensive Care Unit of the a Regional Tertiary Care Hospital at the age of 3.5 months, because of aphonia and severe inspiratory stridor. According to his parents there was no history consistent with upper respiratory infection, trauma, or foreign body aspiration. Direct laryngoscopy was performed and it revealed laryngeal papillomatosis, so he was sent to Heim Pal Children's Hospital in
Discussion
Recurrent laryngeal papillomatosis (RRP) is a relatively rare condition, incidence rates are 1–4/100,000 [1]. The disease develops as a consequence of vertical infection from the mother by the human papilloma virus (HPV), most frequently by the HPV types 6 and 11 [2]. The clinical course of the disease is rather unpredictable – some patients recover spontaneously, most have slowly growing lesions with a mild course, while in rare cases the disease course is severe, with violent progression
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Human Papillomavirus Vaccination as an Adjuvant Therapy for Recurrent Respiratory Papillomatosis: Additional Case Series
2024, Journal of VoiceCitation Excerpt :Recurrent respiratory papillomatosis (RRP), mainly caused by human papillomavirus (HPV) infection, is one of the most difficult to cure among neoplasms arising in the upper airway tract. Moreover, some studies have reported that RRP is associated with life-threatening diseases, such as malignant transformation1 and airway obstruction.2 The mainstream treatment for RRP has been surgical procedures, although patients with RRP frequently develop recurrence after these procedures.
Systematic review of the use of human papillomavirus vaccine as adjuvant therapy for juvenile-onset recurrent respiratory papillomatosis
2022, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :In this review, intramuscular injections of three doses of quadrivalent HPV vaccines were given to patients in the studies at the recommended dosing schedule, except patients in Zhang et al. received three doses of HPV type 6 L1 VLPs at day 3, week 4, and week 8 [18]. The assessment of the outcome measures evaluated (number of surgeries during the follow-up period, ISI, SPM, Derkay or severity scores, and remission status) revealed that eight out of twelve studies included in the review showed potential benefits from the administration of the vaccine as a treatment modality compared to surgical interventions and/or concurrent adjuvant therapies alone [12–14,18–21,24]. In contrast, two studies showed that the vaccine does not have a therapeutic effect against established infections of RRP.
Trends in recurrent respiratory papillomatosis treatment
2021, Acta Otorrinolaringologica EspanolaThe human papillomavirus vaccine as a treatment for human papillomavirus–related dysplastic and neoplastic conditions: A literature review
2020, Journal of the American Academy of DermatologyHuman papillomavirus types causing recurrent respiratory papillomatosis in Zimbabwe
2019, International Journal of Pediatric OtorhinolaryngologyTherapeutic use of the HPV vaccine in Recurrent Respiratory Papillomatosis: A case report
2017, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :Her shortened ISI necessitated aggressive treatment, and adjuvant therapies were considered to compliment her surgical interventions. The HPV vaccine was considered to be a safe option that other case reports had shown to be effective in treatment, so it was decided to treat with the vaccine [10–16]. The 9-valent vaccine was chosen as this was the vaccine used in affiliated clinic and while the papilloma was shown by hybridization to show serotypes 6/11, the 9 valent vaccine covers additional cancer causing serotypes which can account for 15% of cervical cancers.