Ja. Bernstein et al., EVALUATION AND TREATMENT OF LOCALIZED VAGINAL IMMUNOGLOBULIN E-MEDIATED HYPERSENSITIVITY TO HUMAN SEMINAL PLASMA, Obstetrics and gynecology, 82(4), 1993, pp. 667-673
Background: Localized vaginal inflammation after contact with seminal
plasma has been previously described but without a clear understanding
of the underlying immunopathogenesis. The purpose of this report is t
o describe three women who presented with localized postcoital vaginal
reactions that were successfully treated with rapid immunotherapy usi
ng human seminal plasma proteins. Cases: One atopic and two nonatopic
women with histories of immediate onset of localized postcoital vagina
l symptoms and immediate skin test reactions to human seminal plasma w
ere treated with rapid immunotherapy using their spouse's purified sem
inal plasma protein fractions. One of the women had decreased cutaneou
s reactivity post-therapy and detectable circulating specific immunogl
obulin (Ig) G and IgE antibodies to her spouse's fractionated seminal
plasma proteins. Increased IgG, IgE, and IgA antibodies were found in
these patients' sera to whole seminal plasma of a normal male control
and to fractionated proteins of different men, indicating that one or
more homologous seminal plasma proteins may be responsible for these r
eactions. Their localized vaginal symptoms resolved completely after r
apid immunotherapy treatment. Two of the women have remained symptom-f
ree, whereas the third woman had recurrent localized vaginal symptoms
after failing to maintain frequent sexual intercourse after treatment.
Conclusions: Rapid immunotherapy immediately alleviated vaginal react
ions to seminal plasma in all patients. These cases indicate that the
pathogenesis of some localized vaginal inflammatory reactions may invo
lve IgE-mediated or other immune responses to human seminal plasma pro
teins.