ABSTRACT
Background: The aim of this study was to document the clinical
features of children with mosquito allergy and investigate the possible
associations between demographic features and type of reactions in this
population.
Methods: Children with large local or unusual reactions after
mosquito bites who attended to our outpatient pediatric allergy
department were enrolled in the study along with control subjects.
Results: A total of 180 children (94 with mosquito allergy and
86 age and sex-matched control subjects) with a median age of 6.8 years
(IQR 5.5-9.3) were enrolled. Atopy (35.1% vs. 11.6%,
p<0.001) and grass pollen sensitization (28.7% vs. 8.1%,
p<0.001) were significantly more frequent in children with
mosquito allergy. Skin prick test with mosquito allergen was positive in
only 6 children (6,4%). Grass pollen sensitization was most common in
children (28.7%) followed by sensitization to house dust mite (9.6%).
30 children (31.9%) had an accompanying atopic disease such as allergic
rhinitis, asthma or atopic dermatitis. Bullae were significantly more
frequent in children with asthma (41.7% vs.15.9, p=0.034). The median
duration of symptoms after onset were significantly longer in patients
with ecchymosis, with immediate wheals and in children whose symptoms
start in 20 min to 4 hours after mosquito bites.
Conclusions: Our results indicate that the role of commercially
available tests in the diagnosis of children with mosquito allergy is
limited. There is an association between unusual, large local or
exaggerated reactions after mosquito bites and allergic diseases in
children. The severity of reactions increases with age and particularly
in children with atopic background.
Keywords: children, large local reaction, mosquito allergy,
large local reaction, unusual reaction