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Q J Med 1990; 75: 371-376
© 1990 Association of Physicians

other

A New Manifestation of Seminal Fluid Hypersensitivity

NIGEL MIKE*,, GRAHAM BIRD{dagger} and PETER ASQUITH*

*Alistair Frazer and John Squire Metabolic and Clinical Investigation Unit, East Birmingham Hospital Bordesley Green East, Birmingham {dagger}Blood Transfusion Service, Royal Infirmary 421 Laurenston Place, Edinburgh

Address correspondence to Dr N. Mike, East Birmingham Hospital, Bordesley Green, Birmingham B9 5ST.

Accepted for publication 13 October 1989.

An immediate hypersensitivity reaction to seminal fluid is an uncommon but well recognized condition. We describe a young woman who developed haemorrhagic proctitis, arthralgia and urticaria on honeymoon. Investigations suggested an immune complex (type III) hypersensitivity. It subsequently became clear that her symptoms were temporally related to sexual intercourse. After 8 hours she developed nasal congestion and urticaria followed by migratory arthralgia and periorbital oedema. Over the ensuing 24 hours she had diarrhoea, occasionally with blood. She became breathless and had evidence of a restrictive ventilatory defect. These symptoms improved over 4–5 days. Further in vitro investigations were inconclusive but intradermal skin testing with seminal plasma led to recurrence of all her symptoms. Symptoms ceased with condom usage, and the condition abated over 2 years.

This patient is unique in that seminal fluid hypersensitivity appears to have produced a type III immune response.


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