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Re: ?? vaginitisFrom: dahmd@gate.netThu Mar 6 22:13:13 1997
In article Bernard Cristalli <bclaure@club-internet.fr> writes:
>I saw this morning (10 AM Paris time) a 30 YO pre menopausal woman para Bernard- There have been rare reported cases of semen allergy in the literature. These usually present immediately after ejaculation (obviously no symptoms with a condom) with symptoms including vulvar edema, erythema, varying degrees of pain, and even systemic symptoms such as face and hand edema and anaphylaxis. Diagnosis is by symptomatology and skin testing with semen (I have no idea how to do this). One study reported that all 4 female members of a family developed severe symptoms after each unprotected intercourse! I suppose asking patients to report symptoms with and without condoms would also help make the diagnosis. Treatment includes taking benadryl or another antihistamine prior to intercourse, desensitization (don't know how to do this either, although it sounds kind of fun), and immunotherapy with subcutaneous injections of seminal plasma. Some references: Evaluation and treatment of localized vaginal immunoglobulin E-mediated hypersensitivity to human seminal plasma. Bernstein JA et al. Obstet Gynecol 1993;82:667-73. Familial allergic seminal vulvovaginitis. Chang T. AJOG 1976;442. Allergy to human seminal plasma. Levine B et al. NEJM 1973;288:894. Localized and systemic hypersensitivity reactions to human seminal fluid. Bernstein et al. Ann Int Med 1981;94:459. Good luck with your patient. I will be offline for about a week but look forward to hearing about the outcome of this case. Ashley D. Ashley Hill, M.D. dahmd@gate.net Orlando, FL
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