The Prevalence of Adenoid Hypertrophy among Children with Zika Related Microcephaly

Abstract

Upper respiratory obstruction is a common sequela in children with Zika-related microcephaly (ZRM). As a cross-sectional analysis nested in a cohort study, this study aims to investigate the prevalence of adenoid hypertrophy (AH) in children with ZRM and symptoms of respiratory obstruction. The data were collected in the first three years of life from children with ZRM who were followed in two reference centers for otorhinolaryngological care of patients with congenital Zika syndrome. Out of 92 children with confirmed ZRM, 57 were evaluated by nasopharyngoscopy after presenting with upper respiratory obstruction symptoms. In this study, 31 of the 57 (54%) children with ZRM who were evaluated had obstructive AH. Thirteen children with obstructive AH were submitted to surgery, which resulted in the complete resolution of symptoms for 11, partial resolution in 1, and no improvement in 1. No evidence of direct involvement by Zika virus (ZIKV) infection in the adenoid tissues was demonstrated by histology or immunohistochemistry. Our results suggest that there is a high prevalence and early presentation of AH in children with ZRM, with consequent upper airway obstruction causing upper airway obstructive disorder, secretory otitis media, and dysphagia.

Time to Evaluate the Clinical Repercussions of Zika Virus Vertical Transmission? A Systematic Review

“…These abnormalities were characterized by dilatation of the right atrium and the right ventricle, demonstrating an overload of the right heart chambers. In a study of children with Zika-related microcephaly, adenoid hypertrophy and symptoms of respiratory obstruction were reported ( 40 ).…”

“…In addition, Leal et al ( 40 ) in a cross-sectional study nested in a cohort study, found a high prevalence of adenoid hypertrophy in children with Zika-related microcephaly, with consequent upper airway obstruction leading to chronic upper airway obstructive disorder, secretory otitis media and subsequent dysphagia ( 40 ). Abdominal imaging studies on the other hand showed no characteristic findings that were higher than those observed in the general population ( 55 ).…”

The legacy of ZikaPLAN: a transnational research consortium addressing Zika

“…Of note, the MERG pediatric cohort is one of the largest single cohort studies of children with CZS in the world. The MERG pediatric cohort study published several case series reporting on microcephaly [ 24 ], prenatal and postnatal brain imaging abnormalities [ 25 , 26 ], oropharyngeal dysphagia [ 27 ], early epilepsy [ 28 , 29 ] and rare complications such as cryptorchidism [ 30 , 31 ], endocrine dysfunctions [ 32 ], and adenoid hypertrophy [ 33 ] over the first years of life. Longer term follow-up of the prenatally exposed infants also found markedly elevated frequencies of seizures, ophthalmologic abnormalities, and hearing deficits in infants born with microcephaly or born small for gestational age relative to exposed infants born without microcephaly and normal or large for gestational age [ 34 ].…”

Role of Laryngopharyngeal Reflux Changes in Children with Adenoid Hypertrophy: A Randomized Controlled Prospective Study

“…Adenoid hypertrophy (AH) is one of the most common respiratory diseases in children. The incidence rates of AH in children and adolescents range from 40 to 71% [ 1 ]. The main clinical symptoms of AH are snoring, mouth-open breathing, nasal congestion, and so on.…”