Schacher Kayla, Dalloul Mudar, Muneyyirci-Delale Ozgul
Department of Obstetrics and Gynecology, University Hospital at Downstate, Brooklyn, New York, USA.
Am J Reprod Immunol. 2024 May;91(5):e13865. doi: 10.1111/aji.13865.
Seminal plasma hypersensitivity (SPH) is a rare and often misdiagnosed condition characterized by local and/or systemic reactions to seminal plasma proteins following exposure to semen. We aimed to summarize key symptomatology, diagnostic features, and management options for SPH.
The databases PubMed, EMBASE, Web of Science, Google Scholar, and Cochrane Review were searched with key words "seminal plasma hypersensitivity" and "seminal fluid allergy" through September 2023. Exclusion criteria included non-English articles, in vitro studies, publication before 1990, duplicates, and articles with no clinical relevance to SPH in women.
The search yielded 53 articles for review. Of these, 60.5% described systemic SPH and 39.5% described localized.
Diagnosis of SPH relies on a thorough patient history and confirmatory skin prick testing. The use of IgE assays is controversial and less accurate for cases of localized SPH. Knowledge of disease immunopathology, systemic versus localized symptom presentation, patient preference, and desire to conceive should guide management options. Artificial insemination has the potential for severe adverse reactions in systemic SPH so necessitates extra procedural precautions. SPH does not appear to impair fertility. Additional research on specific allergens implicated in SPH can aid in the development of more targeted immunotherapy approaches with improved safety and efficacy.
精浆超敏反应（SPH）是一种罕见且常被误诊的病症，其特征为接触精液后对精浆蛋白产生局部和/或全身反应。我们旨在总结SPH的关键症状、诊断特征及管理方案。
通过检索PubMed、EMBASE、科学网、谷歌学术和Cochrane系统评价数据库，使用关键词“精浆超敏反应”和“精液过敏”，检索截至2023年9月的文献。排除标准包括非英文文章、体外研究、1990年以前发表的文献、重复文献以及与女性SPH无临床相关性的文章。
检索共得到53篇文章以供综述。其中，60.5%描述了全身性SPH，39.5%描述了局限性SPH。
SPH的诊断依赖于详尽的患者病史和确诊性皮肤点刺试验。对于局限性SPH病例，IgE检测的应用存在争议且准确性较低。对疾病免疫病理学、全身与局部症状表现、患者偏好以及受孕意愿的了解应指导管理方案的选择。在全身性SPH中，人工授精可能会引发严重不良反应，因此需要额外的操作预防措施。SPH似乎不会损害生育能力。对与SPH相关的特定过敏原进行更多研究，有助于开发更具针对性的免疫治疗方法，提高安全性和有效性。
