Serum sickness-like syndrome due to mosquito bite

Local inflammatory reactions at the site of a mosquito bite are frequent. i mmediate systemic reactions have occasionally been reported The first case of a patient with relapsing episodes of a serum sickness-like syndrome foll owing mosquito bites is reported herein. A 62-year-old patient came to the emergency room complaining of sudden malaise, chills, fever, headache, cerv ical lymph node enlargement arthromyalgia, generalized purpura and leukopen ia 6 h after a mosquito bite. He had experienced multiple similar episodes in the last 20 years, also following mosquito bites infectious and autoimmu ne diseases were ruled out Serum IgE was 9,102 kU/l. Prick test of whole-bo dy 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. pip; lens extract revealed 43 and 17 kDa IgG-binding proteins and 22 and 1 7 kDa IgE-binding proteins, neither of which were found with control sera. Skin biopsy was consistent with leukocytoclastic vasculitis. The presence o f both mosquito-specific IgE and IgG in the patient's serum suggest a possi ble cooperative immune response leading to clinical manifestations of serum sickness.