Seminal Plasma Allergy Research Articles

A Case of Human Seminal Plasma Allergy Diagnosed by Prick Test Using Seminal Plasma.

A Case of Human Seminal Plasma Allergy Diagnosed by Prick Test Using Seminal Plasma.

Can cholesterol metabolism and prostate function be relevant co-factors in Can f 5-related human seminal plasma allergy?

article: Can cholesterol metabolism and prostate function be relevant co-factors in Can f 5-related human seminal plasma allergy? - La Rivista Italiana della Medicina di Laboratorio 2021 Dicembre;17(4):258-60 - Minerva Medica - Journals

Fatal anaphylaxis due to peanut exposure from oral intercourse

BackgroundIntimacy-related allergic reactions, including anaphylaxis, are under-reported due to social stigma, lack of awareness, and misdiagnosis. The differential diagnosis for intimacy-related anaphylaxis is extensive and includes systemic human seminal plasma allergy, exercise-induced anaphylaxis, asthma exacerbation, latex allergy, and transference of food or drug allergens through saliva or seminal fluid.Case presentationTwo adolescents met on a popular dating phone application. One individual had a long-standing history of asthma and peanut allergy. Although they never kissed, the male with peanut allergy received fellatio, while the other male had eaten peanut butter before they met. During fellatio, the peanut allergic male developed respiratory symptoms, used his bronchodilator, and collapsed. He remained unconscious despite aggressive interventions by emergency personnel called to the site. The clinical history and autopsy results suggested anaphylaxis to peanut allergen exposure from the intimate exposure as the cause of death.Discussion and conclusionsTo date, nearly all reported cases of intimacy-related anaphylaxis involve symptomatic women. This is the first report of intimacy-related anaphylaxis involving men who have sex with men and the first report of potential allergen transfer from oral mucosa to a patient receiving fellatio. Based on the paucity of published cases, death from intimacy-related anaphylaxis is exceedingly rare. Post-mortem analysis is inherently difficult, as an elevated tryptase level has myriad potential causes; nevertheless, the authors suggest that intimacy-related anaphylaxis due to peanut allergy is the most likely diagnosis. With increasing popularity of relationship applications, especially amongst stigmatized populations, this case highlights the importance of allergy awareness and patient education to decrease risk, particularly in the adolescent population, who are already at increased risk of severe anaphylaxis. Especially amongst those participating in intimate activities, disclosure of one’s allergies warrants discussion, as the outcome can be fatal. Our case demonstrates the crucial need for increased advocacy in food allergy, education around intimacy-related anaphylaxis, and the importance of allergy awareness and prevention across all populations.

In vitro assessment of human seminal fluid IgE-mediated allergy

Human seminal plasma allergy is a rare clinical entity with symptoms varying from local reactions to life-threatening anaphylaxis after unprotected sexual intercourse. It can be associated with localized urticaria to skin contact and can be more severe as a result of condomless receptive anal sex. The in vitro investigation of specific serum IgE against human seminal fluid and molecular canine allergen Can f 5, cross-reactive with human prostate specific antigen (PSA), may be performed in clinical practice by solid-phase immunoassay methods such as singleplex fluoroimmunoassay and a new generation multiplex macroarray nanotechnology-based immunoassay.

Suspected hypersensitivity to cervicovaginal fluid - what can we learn from the seminal plasma allergy story?

After the first report of seminal plasma hypersensitivity (SPH) in 1958, it took more than 40 years to identify the allergen responsible for these reactions.1, 2 Even in the middle of the 70s, women suffering from allergic reactions against the ejaculate of their partners received the recommendation, ‘that she avoids this gentleman’.3 The first publication about SPH is written in Dutch language.1 The authors used the term ‘merkwaardig’ to describe the reaction of their female patient against seminal plasma. It is worth mentioning that ‘merkwaardig’ may mean ‘remarkable’, ‘strange’, but also ‘funny’ implicating some uncertainty concerning the severity of this reaction. The manuscript by Jankowski et al. reminds one very much of the situation in 1958. Nothing is known about hypersensitivity to cervicovaginal fluid (CVFH). The characterization of this potentially new disease is based on subjective reports from patients and the personal opinion of dermatologists. However, prick tests or determination of specific IgE are not available. This is not surprising, as the allergen(s), that may be responsible for CVFH, have not yet been identified. The fact that CVF contains a variety of components and is mixed with secretions of genital accessory glands does not necessarily mean that isolation of the allergen is not possible. Seminal plasma is also composed of proteins and substances from different anatomical structures such as testicles, epididymis, prostate gland and seminal vesicles (and more!). Suspected CVFH and SPH have one common problem. Genital or general discomfort after sexual intercourse may be caused by organic or psychogenic factors. However, the most important difference is that the composition of CVF differs according to the female cycle and is also influenced by the microbiological microflora.4, 5 Considering these aspects, the Internet-based questionnaire by Jankowski et al. is an important step to draw attention to a problem we do not have enough knowledge about, but we need more data ‘to characterize the population of men with suspected hypersensitivity to cervicovaginal fluid’ and to calculate the prevalence of CVFH. Do men with suspected CVFH notice differences in their complaints, when they have sexual intercourse at different times of their partner's cycle? Do oral contraceptives show effects on the reaction against CVF? Do men with suspected CVFH react differently to different sexual partners? If these data are available, it would be interesting to present them. As several studies have focussed on components of the vaginal or cervical–vaginal fluid,4, 5 it should be technically possible, to gain enough material for allergological tests. In addition, men with suspected CVFH need to be evaluated by physicians trained in sexual medicine. It is likely that some men have really IgE-mediated allergies against CVF. Witkin et al. 6 demonstrated that some men (without symptoms) have IgE antibodies in their seminal plasma that reacted with components of the vaginal fluid of their partners or (in one case) also with that of another woman. The allergens involved were not further characterized. In principle, it seems to be possible that men react specifically to their partners CVF. The consequence of the manuscript by Jankowski et al. will be that more reports about suspected CVFH will be published in the future. This will enable the allergological workup of these patients and their problems. It is hoped that it will not take 50 years to clarify this interesting problem!

Characterization of patients with suspected hypersensitivity to cervicovaginal fluid.

Allergic reaction to seminal plasma was described decades ago. In USA, only tens of thousands women are estimated to be affected. Not only seminal plasma but also cervicovaginal fluid contains sex-restricted antigens, yet allergy to cervicovaginal fluid has never been reported in medical literature. We came to a suspicion that because immunologic tests required to prove such a diagnosis, allergy to cervicovaginal fluid has never been reported yet it is not uncommon. The objective of this study was to use an Internet-based questionnaire to characterize the population of men with suspected hypersensitivity to cervicovaginal fluid. A questionnaire designed to cover localized and systemic symptoms of hypersensitivity reaction was made available via the Internet. Respondents with postcoital adverse reactions were invited to participate. Only respondents who presented with at least two symptoms suggestive to hypersensitivity to seminal plasma or cervicovaginal fluid and were negative for STI, and known hypersensitivity reactions such as latex allergy were a subject for further analysis. Board-certified dermatologists were surveyed for seeing bona fide cases of cervicovaginal fluid hypersensitivity. We have identified 52 cases of suspected hypersensitivity to cervicovaginal fluid (CVF). Both localized and systemic types of hypersensitivity were identified. A substantial number of dermatologists admitted to witnessing cases of hypersensitivity to CVF. Based on data from affected individuals as well as the opinions of dermatologists worldwide, we believe that allergic reaction to cervicovaginal fluid is at least as common as seminal plasma allergy. However, remains unreported due to technical difficulties in diagnosis and dermatologists' disbelief in its actual existence.

精漿アレルギー（Human Seminal Plasma Allergy）の 1 例

精漿アレルギー（Human Seminal Plasma Allergy）の 1 例

Seminal Plasma Allergy : A Literature Review

Seminal plasma allergy (SPA) is an immunological reaction against human seminal plasma observed in women. SPA is not a well‐known clinical syndrome, considering that there are few epidemiological studies on SPA, and it can often be overlooked or misdiagnosed as other medical conditions. Symptoms occur after sexual intercourse and manifest as systemic and/or localized symptoms. The pathophysiology of SPA is commonly assumed to be autoimmune reaction to seminal plasma with IgE antibodies ; however, it is still uncertain which specific antibodies cause SPA. In vivo skin tests, including prick and intradermal tests, are useful for diagnosing SPA. However, there has been no consensus on treatment of SPA, apart from symptomatic therapy, although several desensitization methods have been reported, using emergency kits for allergic reactions. The most common and most effective preventive measure for SPA is to use condoms during intercourse.

Allergic diseases in the genital area

The genital area has a high exposure to various allergens that are not always obvious. Out of shame patients may not complain about symptoms in this area. Moreover, diagnosis and therapy are often not primarily conducted by a dermatologist and allergologist. Therefore, many cases of allergic diseases in the genital area remain undetected. Which typeI and typeIV allergies occur in the genital area? Which allergens are currently of importance? Which are the characteristics of allergic diseases in the genital area? What are the symptoms and differential diagnoses? What to focus on when taking medical history and in clinical diagnostics? The current medical literature regarding allergic diseases in the genital area is discussed. In the genital area typeIV allergies such as contact dermatitis exceed typeI allergies in number. Contact urticaria can occur due to seminal plasma allergy, latex allergy and a transfer of typeI allergens via semen. Contact allergens are found in sex products such as condoms, but also in topical products. Methylisothiazolinone has become a new and important contact allergen for the genital area in recent years. Also, fixed drug eruption occurs preferentially in the genital area. As a delayed typeIV allergy due to systemically administered drugs it has to be considered in the differential diagnosis. Presumably, there are a high number of unreported cases of allergic diseases in the genital area. Interdisciplinary collaboration between gynecologists, urologists and dermatologist should be increased. The use of methylisothiazolinone in rinse-off and leave-on products should be discussed.

A Five-Year Followup of Human Seminal Plasma Allergy in an 18-Year-Old Woman

Case reports of women with the rare condition of human seminal plasma allergy have indicated that the condition may be associated with life-threatening anaphylactic reactions in relation to coitus. Few observations, if any, of long-term outcome of the condition are available. The aim of this paper was to present a case diagnosed in an 18-year-old girl who presented with generalized urticaria, nasal congestion and secretion, conjunctivitis, and periorbital and labial oedema 6–8 hours after coitus. During five years of followup the condition improved clinically significantly. Due to intimacy concerns and the low prevalence of the condition robust long term data on the natural course of the condition are difficult to obtain. The present case suggests that in some patients the condition may improve over time.

Human seminal plasma allergy: successful pregnancy after prophylactic anti-histamine treatment

Human seminal plasma allergy is a rare phenomenon. Its clinical manifestations are diverse, and range from mild local pruritus to fatal anaphylaxis. Treatment varies with severity of the reactions: abstinence, condom usage or immunotherapy (subcutaneous or intravaginal) with seminal fluid. Local allergic reactions can be managed by prophylactic use of antihistamines or local cromolyn cream. A 33-year-old female visited the Asthma and Allergy Clinic in Seoul National University Bundang Hospital for the recurrent generalized urticarial reactions after sexual intercourse. She had been suffering from asthma, allergic rhinoconjunctivitis and atopic dermatitis for 10 years. She gave birth to a baby 6 months ago and no problem before. However, recently she began to recognize unexpected generalized urticaria that occurred after the sexual intercourse with husband. She wanted to have the second baby but hesitated because of the recurrent symptoms after the intercourse. She showed positive response to skin prick test with her husband's seminal fluid. The IgE-binding components were 15, 22, 28, and 35 kDa. Considering her moderate cutaneous reactions, we decided to try prophylactic treatments with oral anti-histamine one hour before sexual intercourse. She did not experience urticarial reactions with intercourse while oral anti-histamine was administered in advance. Finally, treatment outcome was successful, and the couple successfully gave birth to their second baby. We suppose that prophylactic antihistamine may be also applied in seminal plasma allergy patients if systemic reactions are limited to mild to moderate generalized urticaria.

Successful pregnancy by insemination of spermatozoa in a woman with a human seminal plasma allergy: should in vitro fertilization be considered first?

To raise the possibility that pregnancy can be obtained by assisted reproductive techniques in patients with human seminal plasma allergy. Case report. University hospital. A woman consulted for a 3-year primary infertility. She reported lack of intercourse because of a seminal plasma allergy. One intrauterine insemination associated with antihistamine treatment was performed with carefully washed spermatozoa. Immediately after the insemination, the patient had an allergic reaction treated by steroids. Fortunately, this single attempt led to a successful pregnancy, and the patient gave birth to a healthy girl. Pregnancies can be obtained in patients with seminal plasma hypersensitivity by means of intrauterine insemination. However, serious complications may occur after performing intrauterine insemination, which is not a totally reliable method to prevent an allergic reaction. Thus a multidisciplinary team should follow such patients carefully and watch for the potential risks and side effects. In vitro fertilization may represent the more cautious option.

L’allergie au liquide séminal

Human seminal plasma allergy (HSPA) is a rare condition but it is less rare than originally reported. It occurs in two forms: a brutal systemic anaphylactic reaction associated with regional signs (70% of the cases) or as an isolated local reaction masked as chronic vulvovaginitis or as a burning semen syndrome, the accurate etiology of which is not always recognized by gynecologists and general practitioners. New data have confirmed the efficacy of immunotherapy (60–70% in the systemic form). The existence of cross antigenicity between prostatic kallikrein (present in human sperm) and the dog allergen Can f 5, which is a dog prostatic kallikrein, has recently been reported. Reactivity to that 28 kDa molecule, which is present in dog dander extracts, is found in 25 to 70% of the sera of patients allergic to dog dander. This cross-reactivity might explain the occurrence of HSPA in some women during their first sexual intercourse.

Successful pregnancy after artificial insemination in a case of human seminal plasma allergy.

Human seminal plasma allergy in women is uncommon, but causes a variety of serious reactions, including urticaria, dyspnea and vomiting, in those that are affected. Semen barriers, such as condoms, are the most widely advocated method for avoiding these reactions. However, this is not acceptable to couples who wish to have children. We present a case of a woman with human seminal plasma allergy who became pregnant after the eighth cycle of artificial insemination using washed sperm from her spouse. (Reprod Med Biol 2008; 7: 119-122).

Allergy to human seminal fluid: Cross-reactivity with dog dander

Human seminal plasma (HSP) allergy is uncommon, with symptoms ranging from vulvovaginal pruritus to life-threatening anaphylaxis. Although several seminal plasma allergens have been reported and their molecular masses have been estimated to range between 12 and 75 kd, the prostate-specific antigen (PSA) has recently been identified as a causative allergen. Given that in a large number of cases symptoms appeared during or after the first intercourse, a cross-reactivity phenomenon might be implicated. We sought to assess the presence of IgE cross-reactivity among proteins from dog epithelium and HSP and to attempt to identify the allergens involved. Forty-one patients with dog epithelium allergy were selected. One of them experienced anaphylaxis in contact with her husband's seminal plasma. Skin prick tests, serum specific IgE measurements, SDS-PAGE immunoblotting, and inhibition tests were performed to study the pattern of IgE-binding proteins and the potential cross-reactivity between HSP and dog epithelium. Mass spectrometry was carried out to identify the protein involved in allergy reactions. Twenty-four percent of the sera from patients with dog epithelium allergy recognized an IgE-binding band of 28 kd in HSP immunoblotting. Mass spectrometry identified this band as the PSA. SDS-PAGE immunoblotting-inhibition showed a complete IgE-binding inhibition when sera from these patients were preincubated with dog dander extract. IgE cross-reactivity among proteins from dog dander and human PSA is demonstrated.

Typ-I-Allergie auf Seminalplasma

Human seminal plasma allergy (HSPA) is a rare allergic reaction to specific protein fractions of seminal plasma, whereof PSA seems to be a relevant allergen. Predominantly Type I-immunoreactions can occur. The main symptoms are localized and generalized urticaria and sometimes anaphylactic symptoms. The diagnosis is based on history, skin tests and on the determination of specific IgE-levels for (un)fractionated seminal plasma. Here we report a patient with recurrent episodes of generalized urticaria after unprotected sexual intercourse and positive prick-test-reaction on seminal plasma.

Human seminal plasma allergy – a rare cause of recurrent anaphylaxis

Allergies to sperm are very uncommon. A 23-year old woman with atopic dermatitis complained of three attacks of angioedema, urticaria, wheezing and weakness. When questioned about factors causing exercise-induced anaphylaxis, the patient reported having had sexual intercourse with the same partner one hour before each event. When using condoms, no symptoms occurred. Human seminal plasma allergy was confirmed by positive skin testing with the partner's sperm. Specific IgE-antibodies against human seminal plasma were not found. The patient received an emergency kit for anaphylaxis.

Asthma, Hypersensitivity, and Coitus

Dr. Kuna and colleagues (1) report an uncommon cause of asthma exacerbations after unprotected coitus in a 48-year-old male. The patient had aspirin-sensitive asthma, and the postcoital exacerbation was attributed to the aspirin ingested by his wife. The diagnosis was suspected because symptoms did not occur after condom usage. The objective of this communication is to highlight other manifestations of asthma and hypersensitivity reactions that can be related to coitus. Sexual activity can trigger off asthma in more ways than one (2). Asthma associated with coitus can be categorized as human seminal plasma allergy (HSPA) in female subjects (3), postcoital asthma and/or rhinitis (4), condom-induced asthma (5), and asthma subsequent to transfer of allergens during coitus (1, 3, 6). The latter three can occur in both sexes. In female subjects, HSPA may present as asthma along with other hypersensitivity manifestations (3). This little-known disorder is caused by sensitization to proteins present in the seminal fluid, and occurs during or soon after coitus. The symptoms are thought to be mediated by the classical IgE-mediated pathophysiologic mechanism. Postcoital asthma (“sexercise-induced asthma”) and rhinitis (“honeymoon rhinitis”) are not exercise-induced (athlete’s nose) and cannot be ascribed to any cause other than sexual excitement (4). Anxiety and apprehension are a predominant feature in both patients and their partners. Intense emotional stimuli during sexual intercourse can possibly lead to autonomic imbalance with parasympathetic overreactivity, thereby releasing mediators and provoking symptoms. Condom usage can not only precipitate an asthmatic attack, but can also cause life-threatening anaphylaxis (5). This is caused by allergy to latex and can occur in either partner. Hypersensitivity reactions have occurred following transfer of allergens present in the seminal fluid. Reports have documented postcoital allergic reactions including asthma in female subjects due to ingestion of walnut, vinblastine, thioridazine, and penicillin by the male partner before coitus (3). Transfer of allergenic material from the vaginal fluid to a male partner during coitus has also been reported in a 34-year-old male, who developed a fixed drug eruption following coitus. His wife had ingested trimethoprimsulphamethoxazole, to which he was known to be allergic (6). The untoward consequences of sexual activity described above are yet to receive the attention they deserve. Life-threatening asthma and anaphylaxis have been documented subsequent to coitus (2). These phenomena may easily be overlooked due to patient embarrassment and lack of physician awareness.

Human seminal plasma allergy: a review of a rare phenomenon.

Clinical & Experimental AllergyVolume 34, Issue 6 p. 827-838 Human seminal plasma allergy: a review of a rare phenomenon A. Shah, A. Shah Department of Respiratory Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, IndiaSearch for more papers by this authorC. Panjabi, C. Panjabi Department of Respiratory Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, IndiaSearch for more papers by this author A. Shah, A. Shah Department of Respiratory Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, IndiaSearch for more papers by this authorC. Panjabi, C. Panjabi Department of Respiratory Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, IndiaSearch for more papers by this author First published: 14 June 2004 https://doi.org/10.1111/j.1365-2222.2004.01962.xCitations: 42 Prof. Ashok Shah, Department of Respiratory Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, P.O. Box 2101, Delhi 110 007, India. E-mail: ashokshah99@yahoo.com Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume34, Issue6June 2004Pages 827-838 RelatedInformation

Asthma Caused by Human Seminal Plasma Allergy

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.