EVALUATION AND TREATMENT OF LOCALIZED VAGINAL IMMUNOGLOBULIN E-MEDIATED HYPERSENSITIVITY TO HUMAN SEMINAL PLASMA

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.