Laryngeal Papilloma Presenting as Steroid-Dependent Asthma in a 3-Year-Old Child Without Recurrent Stridor

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Abstract:

Upper airway obstruction is well described as a cause of apparent asthma. However, it can be very difficult to diagnose in young children. This 3-year-old male presented with a 1-year history of severe recurrent wheezing with six emergency room visits in the previous 5 months. Cromolyn, inhaled corticosteroids, and frequent predinisolone bursts had not controlled the wheezing. There was no history of barky cough, croup, or stridor. His physical examination was notable for marked nasal obstruction. At initial presentation, his lungs were normal with no wheezing or stridor. Soft tissue neck X-ray films suggested the presence of a subglottic mass. A large solitary papilloma was found on bronchoscopy. After surgical removal, there was no further wheezing noted by either the parents or his physicians. Laryngeal papillomatosis may mimic asthma in the absence of symptoms of hoarseness, croup, or stridor. It should be particularly considered in 2 to 4-year-old children with recurrent wheezing that is poorly responsive to aggressive therapy including oral corticosteroids.

Document Type: Research Article

DOI: http://dx.doi.org/10.2500/108854198778557980

Publication date: January 1, 1998

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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