Semen allergy L25.9

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Semen allergy (engl.); Seminal plasma hypersensitivity (engl.)

History
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Specken, 1958

Definition
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Rare IgE-mediated type I allergy to protein components of the seminal plasma. The main allergen is prostate specific antigen (PSA), which is found in the semen of all men (see also Burning-Semen-Syndrome).

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Allergology

Benzalkonium chloride

Substance belonging to the disinfectants(INCI name: benzalkonium chloride)

Occurrence/Epidemiology
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Prevalence and incidence are largely unknown. Estimates are available for the USA. It is estimated that up to 40,000 women are affected.

Manifestation
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Affected are women (mostly atopic women) between 20-30 LJ.

Clinical features
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Mostly local symptoms with erythema, itching, contact urticaria. Furthermore: chronic vulvovaginitis, vulva eczema and a " Burning Semen syndrome". Generalized symptoms are found in about 20% of patients: generalized, raised, sharply defined, palpable, solitary or confluent, itching, burning, whitish to red urticaria. The size of the efflorescences can be very variable, from pinhead-sized to extensive.

Diagnosis
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Medical history regarding the symptoms (ask about the use of condoms!), prick tests with fresh, undiluted sperm. Centrifugation of the sperm (division into spermatozoa and seminal plasma), then possibly intracutaneous testing (seminal plasma dilutions have been tested positive intracutaneously in individual cases).

Differential diagnosis
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Latex allergy (condoms); allergies to lubricants or spermicidal substances in vaginal contraceptives.

Complication(s)
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bronchial asthma, anaphylactic shock, allergic rhinitis

Therapy
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Use of condoms.

Before sexual intercourse systemic antihistamines or creams containing 4-8% cromoglycine.

Hyposensitization: In case of strong anaphylactic reactions, hyposensitization (e.g. "rush therapy", see above) can be performed. Several cases have been described in which hyposensitization via a so-called "rush therapy" was successful.

Desired pregnancy: In case of minor allergic symptoms, women can avoid the use of condoms during their fertile days.

Alternative: Artificial insemination

Note(s)
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More rarely, drugs (e.g. penicillin) or food (e.g. walnuts) that have been transferred into the sperm can trigger an allergic reaction.
Semen allergy does not mean infertility (see below intrauterine insemination).

Literature
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Eubel J et al.(2015) Allergic diseases in the genital area. Dermatologist 66:45-52.
Jones WR (1991) Allergy to coitus. Aust N Z J Obstet Gynaecol 31:137-141.
Kint B et al (1994) Combined allergy to human seminal plasma and latex: case report and review of the literature. Contact dermatitis 30:7-11.
Mathelier-Fusade P et al. (2001) Allergy in women. Allerg Immunol (Paris) 33:395-398.
Nist GC et al (2007) Human seminal plasma allergy--a rare cause of recurrent anaphylaxis. J Dtsch Dermatol Ges 5: 34-35
Orta M et al (2003) Anaphylactic reaction after artificial insemination. Ann Allergy Asthma Immunol 90:446-451.
Resnick DJ et al (2004) The approach to conception for women with seminal plasma protein hypersensitivity. Am J Reprod Immunol 52:42-44.
Schwarz I et al.(2016) Mucosal diseases from an allergological point of view. dermatologist 67: 780-785
Shah A et al(2004) Human seminal plasma allergy: a review of a rare phenomenon. Clin Exp Allergy 34:827-838.
Weidinger S et al (2005) IgE-mediated allergy against human seminal plasma. Chem Immunol Allergy 88:128-q38.