title: Mosquito allergy in children: Clinical features and limitation of commercially-available diagnostic tests.
abstract: OBJECTIVE
  To determine the clinical features of mosquito allergy in children and the ability of commercially available mosquito allergy tests to detect children with mosquito allergy in Thailand.
  
  
  METHODS
  Patients with mosquito allergy aged 1 month to 18 years were recruited. Demographic data, history of mosquito allergy (onset of the reaction, reaction type) and clinical features were recorded. A skin prick test using a commercially available whole body allergen extract from Culex pipiens was performed, and serum was tested for specific IgE antibodies to Aedes communis whole body extract.
  
  
  RESULTS
  A total of 50 patients with mosquito allergy were enrolled. The median age of enrolled children was 6.2 years with an average age of onset of 2 years [interquartile range (IQR) 1-6]. Half of the children were female. The most common skin lesion from mosquito allergy was erythematous papules (n = 45, 76.3%). The majority of children (58%) were in stage 3 (immediate and delayed type of reactions). One child (2%) was in the desensitization stage after 4.6 years of symptoms. The causative mosquito species could be identified only in 26 (52%) children: 16 (32%) children were positive for Aedes communis, 17 (34%) children were positive for Culex pipiens and 7 (14%) children were positive for both Aedes communis and Culex pipiens. Having positive IgE antibodies against Aedes communis was significantly more common in boys (n = 13, 48.1%) than girls (n = 3, 13%) (p < 0.01).
  
  
  CONCLUSIONS
  Immediate and delayed skin reaction is the most common manifestation in mosquito allergy children. Commercially available tests for mosquito allergy can detect only 30-50% of children with mosquito allergy.
authors.affiliation: Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Wiparat
authors.initials: W
authors.lastname: Manuyakorn
authors.affiliation: Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Sulak
authors.initials: S
authors.lastname: Itsaradisaikul
authors.affiliation: Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Suwat
authors.initials: S
authors.lastname: Benjaponpitak
authors.affiliation: Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Wasu
authors.initials: W
authors.lastname: Kamchaisatian
authors.affiliation: Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Cherapat
authors.initials: C
authors.lastname: Sasisakulporn
authors.affiliation: Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Wanlapa
authors.initials: W
authors.lastname: Jotikasthira
authors.affiliation: Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand.
authors.forename: Ponpan
authors.initials: P
authors.lastname: Matangkasombut
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000276:immunology; D000818:Animals; D002648:Child; D002675:Child, Preschool; D009033:Culicidae / Q000276:immunology; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology*; D007073:Immunoglobulin E / Q000378:metabolism; D007223:Infant; D007299:Insect Bites and Stings / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D019476:Insect Proteins / Q000276:immunology; D008297:Male; D011933:Reagent Kits, Diagnostic / Q000706:statistics & numerical data*; D012882:Skin Tests; D013785:Thailand / Q000453:epidemiology
chemical_list: D000485:Allergens; D019476:Insect Proteins; D011933:Reagent Kits, Diagnostic; D007073:Immunoglobulin E