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Serum sickness-like syndrome due to mosquito bite
P Gaig1, P García-Ortega, E Enrique
1Department of Medicine, Hospital Universitari Joan XXIII, Rovira i Virgili University, Tarragona, Spain.
Summary
This study details the first reported case of recurrent serum sickness-like syndrome triggered by mosquito bites. The patient experienced repeated systemic reactions, suggesting a unique immune response to mosquito allergens.
Area of Science:
- Immunology
- Allergology
- Dermatology
Background:
- Mosquito bites commonly cause local inflammation, with rare systemic reactions.
- Serum sickness-like syndrome (SSLS) is a hypersensitivity reaction typically associated with medications.
- Recurrent SSLS following insect bites is exceptionally rare.
Observation:
- A 62-year-old patient presented with acute SSLS symptoms including fever, rash, and leukopenia 6 hours post-mosquito bite.
- The patient had a 20-year history of similar recurrent episodes linked to mosquito bites.
- Extensive investigations ruled out infectious and autoimmune etiologies.
Findings:
- Elevated serum IgE levels (9,102 kU/l) and positive skin prick test to Culex pipiens were noted.
- Specific IgE to Aedes communis and detection of unique IgG and IgE binding proteins to mosquito extract via immunoblotting confirmed sensitization.
- Skin biopsy revealed leukocytoclastic vasculitis, consistent with SSLS.
Implications:
- This case highlights a unique presentation of recurrent SSLS potentially mediated by mosquito-specific IgE and IgG antibodies.
- It underscores the importance of considering arthropod bites as a trigger for hypersensitivity syndromes.
- Further research into mosquito-allergen interactions may elucidate mechanisms of SSLS and inform diagnostic and therapeutic strategies.