Serum sickness-like syndrome due to mosquito bite.
Local inflammatory reactions at the site of a mosquito bite are frequent. Immediate systemic reactions have occasionally been reported. The first case of a patient with relapsing episodes of a serum sickness-like syndrome following mosquito bites is reported herein. A 62-year-old patient came to the emergency room complaining of sudden malaise, chills, fever, headache, cervical lymph node enlargement, arthromyalgia, generalized purpura and leukopenia 6 h after a mosquito bite. He had experienced multiple similar episodes in the last 20 years, also following mosquito bites. Infectious and autoimmune diseases were ruled out. Serum IgE was 9,102 kU/l. Prick test of whole-body Culex pipiens extract was positive. Specific IgE to Aedes communis was 2.25 kU/l. SDS-PAGE immunoblotting of the patient's serum with whole-body C. pipiens extract revealed 43 and 17 kDa IgG-binding proteins and 22 and 17 kDa IgE-binding proteins, neither of which were found with control sera. Skin biopsy was consistent with leukocytoclastic vasculitis. The presence of both mosquito-specific IgE and IgG in the patient's serum suggest a possible cooperative immune response leading to clinical manifestations of serum sickness.
Department of Medicine, Hospital Universitari Joan XXIII, Rovira i Virgili University, Tarragona, Spain.
P
P
Gaig
P
P
García-Ortega
E
E
Enrique
A
A
Benet
B
B
Bartolomé
R
R
Palacios
D000818:Animals; D000941:Antigens / Q000032:analysis / Q000737:chemistry; D009033:Culicidae; D006801:Humans; D015151:Immunoblotting; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007299:Insect Bites and Stings / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012713:Serum Sickness / Q000209:etiology*; D012882:Skin Tests; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000209:etiology
D000941:Antigens; D007074:Immunoglobulin G; D007073:Immunoglobulin E