Effectiveness of the human papillomavirus (types 6, 11, 16, and 18) vaccine in the treatment of children with recurrent respiratory papillomatosis
Juliana Sato HermannLily Yin WeckxJ M NurmbergerGildo SantosAntônio Carlos Campos PignatariShirley Shizue Nagata Pignatari
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Recurrent Respiratory Papillomatosis
Papillomatosis
Recurrent respiratory papillomatosis is caused by the Human Papilloma Virus and occurs primarily in children and adolescence. Most commonly, disease remains localized to the larynx and spontaneously regresses, but in rare cases there may be pulmonary involvement. We present a case of a 17 year old female with recurrent respiratory papillomatosis who develops pulmonary involvement in the form of squamous papilloma. We present the clinical findings; discuss the potential for malignant transformation and the need for screening and prevention. Keywords: Respiratory papillomatosis, recurrent tracheal papillomatosis, squamous papilloma
Recurrent Respiratory Papillomatosis
Papillomatosis
Malignant Transformation
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Recurrent respiratory papillomatosis (RRP) caused by human papilloma virus is a benign neoplasm, and primarily involve the epithelial mucosa of the respiratory tract. RRP may occur anywhere in the respiratory tract with a predilection at the larynx and could cause life-threatening airway obstructions. We reported a 5-year-old boy with RRP presenting with dysphonia and respiratory difficulties. Therapeutic management of RRP are discussed and reviewed.
Recurrent Respiratory Papillomatosis
Papillomatosis
Respiratory tract
Respiratory Mucosa
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The clinic flow of RRP is very variable and unpredictable. The author looks at some of the basic causes for the frequency of the recidives in the recurrent respiratory papillomatosis, like the age when the disease occurred, the type of the papilloma virus and its presence in clinically normal tissues. The role of surgical trauma and the condition of the immune system are also discussed. The aggressive flow and the higher frequency of the recidives, can be observed in the early stages of the disease, by the isolating of HPV-11 and embracing of more than one level of the larynx. In the aggressive form of RRP in childhood, a more frequent extralaryngeal spread of the papillomas is established and the continuity of the disease is much longer. ----------------------------------- Клиничното протичане на РРП е крайно разнообразно и непредвидимо. Авторът разглежда някои от основните причини за честотата на рецидивите при рецидивиращата респираторна папиломатоза, като възраст на поява на заболяването, типът на папиломния вирус и наличието му в клинически нормални тъкани, обсъжда се ролята на хирургическата травма, както и състоянието на имунната система. Агресивното протичане и по-голямата честота на рецидивите се наблюдава при ранно начало на заболяването, при изолиране на HPV-11 и при обхващане на повече от един етаж на ларинкса. При агресивната форма на РРП при децата се установява по-често екстраларингеално разпространение на папиломите и продължителността на заболяването е по-висока.
Recurrent Respiratory Papillomatosis
Papillomatosis
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Recurrent laryngeal papillomatosis is a benign neoplastic disease which is probably caused by but at least associated with the Human Papilloma Virus. It can be of significant importance for the affected patients because of its recurrent clinical course. A wide variety of therapeutic measures have been described including the surgical removal either with conventional instruments or laser. Malignancies developing from papillomas have been reported.The clinical courses of all 95 patients who have been treated for laryngeal papillomatosis since 1960 were analysed retrospectively. The two most common forms of treatment, surgical removal either conventionally or with the use of the laser, were compared. "Hot-start" polymerase chain reaction and Southern blot hybridization were used to detect HPV-DNA. The case reports of all patients developing cancer of the larynx are included.Laryngeal papillomatosis is a disease of all ages, more often first diagnosed before age 10 or after age 30. Puberty had no effect on the clinical course. However, the rate of complications such as tracheostomy and glottic webs was significantly reduced after laser surgery. HPV-DNA was found in 10 of 11 samples. Squamous cell carcinoma subsequently developed in four cases, three of which occurred almost simultaneously and were therefore not included.The term juvenile laryngeal papillomatosis should be replaced by recurrent respiratory papillomatosis. The occurrence of squamous cell carcinomas in patients previously treated for papillomas underlines the need for repeated histological studies. The surgical treatment remains the mainstay in the management of laryngeal papillomatosis. The laser surgical technique is superior to conventional removal. Using the most sensitive and specific methods presently available, HPV-DNA can be detected in a large percentage of laryngeal papillomas.
Recurrent Respiratory Papillomatosis
Papillomatosis
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Introduction Laryngeal papillomatosis, also known as recurrent respiratory papillomatosis (RRP), is caused by the Human Papilloma Virus (HPV). The role of HPV in the pathogenesis of sinonasal inverted papilloma is not yet fully understood. A synchronous occurrence was first described by Oliver et al. in 2019.
Recurrent Respiratory Papillomatosis
Papillomatosis
Inverted Papilloma
Pathogenesis
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This review paper presents the results of the recent studies designed to elucidate the etiopathogenetic role ofhuman papilloma virus infection in the development of respiratory papillomatosis in the children. Special attention is given to the possible pathways and mechanisms of the mother-to-child transmission of papilloma virus, its frequency and risk factors during pregnancy and in the postnatal period. The results of investigations into the frequency of papilloma virus infection in the children are presented along withrisk factors contributing to its persistence and the development ofjuvenile respiratory papillomatosis. The possible approaches to the management of this condition are proposed.В обзоре представлены данные современных исследований по изучению этиопатогенетической роли папилломавирусной инфекции в развитии респираторного папилломатоза у детей. Рассмотрены возможные пути и механизмы, а также частота и факторы риска передачи вируса папилломы человека от матери к ребенку во время беременности, родов и в постнатальном периоде. Приведены результаты исследовательских работ по изучению частоты инфицированности вирусом папилломы у детей, факторов риска персистенции данной инфекции и развития ювенильного респираторного папилломатоза. Предложены возможные пути профилактики вышеназванного заболевания.
Recurrent Respiratory Papillomatosis
Papillomatosis
Persistence (discontinuity)
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Objectives: To compare the clinical course of tracheal, bronchial, and pulmonary papillomatosis with clinical course of laryngeal papillomatosis in children. Study Design: The records of the 448 children with recurrent respiratory papillomatosis treated in St. Vladimir Moscow Children's Hospital between 1988 and 2003 were reviewed. In all cases, the diagnosis was confirmed histologically. Age at onset of symptoms, age at first surgery, number of surgical procedures, mean duration of surgical interval, possible causes, and age at a point of papillomatosis spread in the lower airways and course of the disease were analyzed. Setting: Academic children's hospital. Results: Papillomas extension down to lower airways was observed in 40 children (8.9%). Among 40 patients with lower airway recurrent respiratory papillomatosis, 8 (20%) demonstrated pulmonary involvement. The basic cause of papilloma extension to lower airways appeared to be tracheotomy performed in children with laryngeal papillomatosis (92.5% of cases). Incidence of satellite pharyngeal and esophageal papillomatosis is significantly higher in patients with lower airways papillomatosis, presenting evidence of lager process extension. The clinical course of lower airways papillomatosis is more aggressive as compared with laryngeal papillomatosis, and treatment efficacy in such children is lower. Conclusions: All the patients with laryngeal papillomatosis having a history of tracheotomy require a regular endoscopic control and chest radiographs or computed tomography scanning because tracheal or pulmonary papillomatosis may occur in such patients even several years after decannulation. The prognosis for the disease after development of pulmonary papillomatosis is always serious.
Recurrent Respiratory Papillomatosis
Papillomatosis
Tracheotomy
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The type of human papilloma virus (HPV) was determined in 26 children aged between 1 year 10 months to 15 years 5 months suffering from recurrent respiratory papillomatosis (RRP). Polymerase chain reaction identified DNA of HPV type 6, 11, 16 and 18. HPV DNA was detected in all the patients including fifteen patients infected with HPV type 11; seven patients infected with HPV type 6; four children infected with HPV type 6 and 11. Types 16 and 18 of HPV were not detected. The analysis of RRP course has found that laryngeal papillomatosis runs a more aggressive course in cases with HPV type 11 infection than in those with HPV type 6.
Recurrent Respiratory Papillomatosis
Papillomatosis
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Recurrent Respiratory Papillomatosis
Papillomatosis
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Recurrent Respiratory Papillomatosis
Papillomatosis
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Citations (2)