SELECTED ARTICLES FROM THE RECENT LITERATURE 2005

10/11/05

IgE-mediated allergy against human seminal plasma

Summary
Background - Allergic reactions to human seminal plasma (SP) are relatively rare events that can lead to severe systemic manifestations, including anaphylaxis during/after sexual intercourse.

Findings - IgE-mediated reactions to SP were reviewed by Weidinger et al of the Technical Univ in Munich, Germany. Most reactions occur in women < 40 years old, with an atopic family history. Symptoms start within one hour after contact with SP. They may be: 1) local (itching, burning erythema, edema in sites in contact with SP); 2) systemic - dyspnea, dysphagia, rhino conjunctivitis, generalized urticaria/angioedema, exacerbation of underlying eczema, anaphylaxis. Another recently reported manifestation of SP sensitivity is the "vulvar vestibulitis syndrome" - a local burning sensation. This reaction may be associated with infertility or not. The nature of sensitizing antigens in SP has not been clearly defined but may include some proteins of prostatic origin.

The diagnosis of SP allergy is based on history and demonstration of specific IgE reactivity vs SP by in vitro serum studies and/or skin test. The simplest therapeutic option is avoidance by use of condoms, although attempts at desensitization to SP have been made.

Reference
Clin Immunol Allergy 2005;88:128-38

Editor's Comments
The currently reported cases of SP allergy may well be an under estimate because of a sizable number of under-reported cases. One has to differentiate SP reactions from allergic reactions to latex (in condoms), spermicidal agents or components of lubricants. Some investigators have found that the sensitizing component in SP may vary from one affected patient to another.

 

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