精液超敏反应

Seminal fluid hypersensitivity

精液超敏反应(SFH)是指患者暴露于精液后局部或全身出现的临床症状,主要见于女性对男性精液的超敏反应,也有男性对自体精液发生超敏反应的报道。关于精液超敏反应的发病率及流行病学情况目前尚不清楚。女性对男性精液的超敏反应绝大部分由典型的Ⅰ型超敏反应所介导,可出现局部瘙痒和组织肿胀、全身荨麻疹、血管神经性水肿、哮喘、致命的严重变态反应等。引起女性精液超敏反应的主要变应原是前列腺特异抗原(PSA),初次接触精液即出现症状的患者可能与其之前接触犬有关系,典型病史及精液变应原检测有助于诊断。使用避孕套有良好的预防效果,服用抗组织胺药物及脱敏疗法是有效的治疗方法。男性对于自体精液的的超敏反应症状包括射精后出现严重的肌肉疼痛、极度虚弱、情绪障碍、流感样表现等。关于男性精液超敏反应的发病机制目前争论较多,尚无公认的观点。与射精相关的典型症状可以帮助诊断,而治疗方法尚在探索之中。SFH的防治仍需更多的研究,以便使更多的医生和患者了解此类疾病并寻找更加有效的诊疗方法。

Seminal fluid hypersensitivity,as a spectrum of systemic or localized clinical symptoms after exposure to seminal fluid,is mainly manifested as women＇ s hypersensitivity to male semen,but there are also few case reports of men＇ s hypersensitivity to autogenous semen. The morbidity and the other epidemiological data of this disease are still unknown. The hypersensitivity of women to male semen was mediated by classical type I allergic reaction in great majority,whose manifestations were local pruritis and edema,generalized urticaria,angioedema,wheezing and life-threatening anaphylaxis. Prostate-specific antigen is regarded as the major allergen involved in hypersensitivity of women to male semen. The patients could be suffering of seminal fluid hypersensitivity during first-time sexual intercourse due to previous sensitization on the basis of exposure to dogs.Diagnosis should be based on clinical history and specific detection of seminal fluid allergen. Prevention such as avoidance of contact by using condoms,antihistamine and specific immunotherapy are effective treatment methods. The manifestations of hypersensitivity of men to autogenous semen included severe myalgia,extreme fatigue and mood disturbances associated with a flu-like status after ejaculation. The pathogenesis of hypersensitivity of men to autogenous semen is sill controversial. Typical symptoms related to ejaculation can be of help for diagnosis,and treatment is still being explored. More research work should be focused on prevention and treatment of seminal fluid hypersensitivity,resulting in more effective diagnosis and treatment methods and more attention of doctors and patients on this disease in the future.