Successful treatment of severe respiratory papillomatosis with intravenouscidofovir and interferon alpha-2b

In contrast to uncomplicated juvenile laryngeal papillomas which may regres s spontaneously, papillomatosis involving pulmonary parenchyma is associate d with a poor outcome. This report represents the case of a 34 yr-old female in whom respiratory p apillomatosis resulted in voice problems and recurrent pneumonias due to br onchial obstruction. A computed tomographic scan of the chest showed worsen ing bilateral round cavitating consolidations. Bronchoscopy revealed polypo id lesions of the right vocal cord and the midtrachea which were confirmed as squamous papillomatosis by histology. Interferon (IFN)alpha -2b treatment was inefficient as was cidofovir monoth erapy. on a maintenance basis. Six months of IFN-alpha -2b and cidofovir in combination led to a complete macroscopic disappearance of the laryngeal l esions and to an impressive regression of the tracheal papillomas and of th e intrapulmonary consolidations. These data provide support that severe respiratory papillomatosis can be sa fely treated by interferon alpha -2b and cidofovir in combination. Probably the same mechanisms as in ribavirin plus interferon alpha -2b, in the trea tment of patients with chronic hepatitis C, are responsible for the therape utic success in this case.