Shah Ashok, Panjabi Chandramani, Singh A B
Department of Respiratory Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
J Asthma. 2003 Apr;40(2):125-9. doi: 10.1081/jas-120017982.
Human seminal plasma allergy (HSPA) in women is a rare phenomenon and can be life-threatening. Hypersensitivity reactions occur during or immediately after coitus and are usually caused by sensitization to proteins in the seminal fluid. This can be very distressing for the patients and their partners. Young, married female patients with episodic asthma dating to their marriage with a history of difficulty in conceiving were specifically asked for local and systemic symptoms chronologically related to coitus. This methodology was adopted keeping in view our social conditions and sensitive nature of the information sought. Two patients thus detected were evaluated further. Condom usage, on our advice, abolished both local and systemic postcoital symptoms. Both patients tested positive to intradermal skin test with the seminal plasma antigen (SPA) derived from their respective husbands and, in patient 1, was accompanied by intense burning, irritation, and itching of the skin. Specific IgE against SPA was demonstrated in the serum of both patients. Elevated levels of total IgE were also detected. A high index of suspicion is needed to diagnose HSPA, especially the local forms, which can easily be overlooked due to patient embarrassment and lack of physician awareness.
女性的人类精浆过敏(HSPA)是一种罕见现象,且可能危及生命。过敏反应在性交期间或性交后立即发生,通常是由于对精液中的蛋白质致敏所致。这对患者及其伴侣来说可能非常痛苦。特别询问了年轻的已婚女性患者,她们自结婚起患有发作性哮喘且有受孕困难史,询问与性交按时间顺序相关的局部和全身症状。考虑到我们的社会状况以及所寻求信息的敏感性,采用了这种方法。由此检测出的两名患者进一步接受了评估。根据我们的建议,使用避孕套消除了性交后的局部和全身症状。两名患者对来自各自丈夫的精浆抗原(SPA)进行皮内皮肤试验均呈阳性,在患者1中,还伴有皮肤强烈的烧灼感、刺激感和瘙痒。两名患者的血清中均检测到针对SPA的特异性IgE。还检测到总IgE水平升高。诊断HSPA需要高度的怀疑指数,尤其是局部形式,由于患者尴尬和医生缺乏认识,很容易被忽视。