Successful intravaginal graded challenge after a systemic reaction with skin prick testing to seminal fluid

摘要

Seminal plasma hypersensitivity (SPH) reactions in women present immediately after contact with seminal fluid as either localized vaginal reactions characterized by vaginal burning, pain, and swelling or as systemic reactions characterized by diffuse urticaria, facial angioedema, dyspnea, or abdominal pain with or without localized symptoms. Here, we report the first case of a 37-year old woman with SPH who experienced a systemic reaction after a skin prick test (SPT) to her spouse's fresh undiluted seminal fluid who later underwent successful intravaginal graded challenge. Our patient described a 17-year history of vaginal itching, localized urticaria, intense labial swelling, and severe gastrointestinal cramping within minutes of exposure to her partner's ejaculate after intercourse. Her symptoms varied in severity and were mild to completely absent when they used coitus interruptus or vinyl condoms, respectively. Her history was significant for 1 emergency room visit immediately after intercourse. She was not treated with epineph-rine and was not prescribed self-injectable epinephrine. She reported a history of latex allergy (self-diagnosed) after 1 experience using a latex condom when she initially became sexually active and subsequently has avoided all latex-containing products.