DIFFUSE RECURRENT RESPIRATORY PAPILLOMATOSIS AFTER IMMUNOSUPRESSIVE THERAPY

TOPIC: Chest Infections TYPE: Fellow Case Reports INTRODUCTION: Recurrent respiratory papillomatosis (RRP) is a rare disease characterized by lesions within the tract secondary to human papilloma virus (HPV) [1]. The carries bimodal distribution, further classified as juvenile or adult onset dependent on age at diagnosis. Juvenile-onset RRP thought be vertical transmission birth, and often self-limiting with cessation around 9 [2]. Although up 47.9% of patients may experience recurrence requiring intervention after 14, etiology not well Here we present case recurrent associated systemic lupus erythematosus (SLE) initiation immunosuppressive therapy. CASE PRESENTATION: A 36 year old female smoker past medical history juvenile-onset SLE presented progressive dyspnea cough, was found have tracheal bronchoscopy. She initially diagnosed 3, multiple vocal cord excisions remission 9. Subsequently 30. started hydroxychloroquine mycophenolate mofetil, then only symptomatic improvement. Six years later, she 90% obstruction from papillomatosis. Electrocautery used for debulking cidofovir injections. Over course two years, patient underwent six bronchoscopies electrocautery, argon plasma coagulation (APC), cryotherapy. Patient unfortunately lost follow-up right mainstem lesion bilateral cavitary representing intraparenchymal spread. At time report, continues undergo surveillance bronchoscopy every three months management central airway disease. DISCUSSION: While delineation argued literature, 20 clearly defined form [1-3]. papillomas in adult-onset are solitary, less likely spread than aggressive nature this most consistent RRP. Her correlates diagnosis To our knowledge, first report diffuse, following CONCLUSIONS: diffuse treatment erythematosus. REFERENCE #1: Fortes, H.R., et al., papillomatosis: state-of-the-art review. Respir Med, 2017. 126: p. 116-121. #2: Xiao, Y., Long-term outcomes Clin Otolaryngol, 2021. 46(1): 161-167. #3: Derkay, C.S. A.E. Bluher, Update Respiratory Papillomatosis. Otolaryngol North Am, 2019. 52(4): 669-679. DISCLOSURES: No relevant relationships Raed Alalawi, source=Web Response Lisa Jarnagin,