title: Inhaled cidofovir as an adjuvant therapy for recurrent respiratory papillomatosis.
abstract: A previously healthy, full-term, 4-month-old boy presented with progressively weakening cry, hoarseness, and increased work of breathing. Flexible fiberoptic laryngoscopy revealed glottic papillomas, which were endoscopically removed with a microdebrider in the operating room (Derkay score 23). The patient was diagnosed with recurrent respiratory papillomatosis that disseminated throughout his airway. Despite biweekly serial microdebridements, intralesional cidofovir, and systemic interferon-α, the patient's health declined substantially (Derkay score 40), culminating in a 47-day hospitalization due to complications of his disease. Inhaled cidofovir was initiated after all conventional treatments had failed. Within 6 weeks of therapy (40 mg daily per treatment, 12 days on and 2 days off), the papillomatous disease improved substantially (Derkay score 23). While inhaled cidofovir appeared to significantly reduce papillomatous disease burden in this patient, further investigation into its long-term effectiveness and safety profile is necessary.
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Ksiazek
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Prager
authors.forename: Gordon H
authors.initials: GH
authors.lastname: Sun
authors.forename: Robert E
authors.initials: RE
authors.lastname: Wood
authors.forename: Ellis M
authors.initials: EM
authors.lastname: Arjmand
mesh_terms: D000280:Administration, Inhalation; D000336:Aerosols; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000998:Antiviral Agents / Q000008:administration & dosage*; D000077404:Cidofovir; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D007223:Infant; D015552:Injections, Intralesional; D008297:Male; D056687:Off-Label Use; D063065:Organophosphonates / Q000008:administration & dosage*; D030361:Papillomavirus Infections / Q000188:drug therapy; D012141:Respiratory Tract Infections / Q000188:drug therapy
chemical_list: D000336:Aerosols; D000970:Antineoplastic Agents; D000998:Antiviral Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir