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Human seminal plasma allergy (HSPA) is a rare phenomenon in women that was first described by Specken in 19581 andwhichwas thought to be an allergic reaction to a specific protein in seminal plasma. The clinical responses vary from local reactions (e.g., vulvar and vaginal itching and erythema) to life-threatening anaphylaxis. While the mechanism underlying HSPA is unclear, prostate-specific antigen (PSA) is thought to be a causative allergen.2,3 We describe a patient with HSPA who developed anaphylaxis after coitus. A 37-year-old woman presented with a history of anaphylactic reaction 30 min after sexual intercourse with her husband. She developed general urticaria, swelling of her lips and eyelids, cough and dyspnea. She took oral antihistamines, and the symptoms disappeared within several hours. She experienced vulvar and cutaneous itching, erythema and swelling immediately after contact with seminal fluid a few months before developing the anaphylactic reaction. The use of a condom during sexual intercourse prevented these symptoms. Her medical history included chronic thyroiditis. She was treated with levothyroxine sodium and was symptomfree. She had only experienced mild atopic dermatitis in early infancy and had no eczema when she was referred to our hospital. She experienced an extrauterine pregnancy at 21 years of age. A laboratory examination revealed a total serum IgE titer of 158 IU/ ml. Her specific IgE antibody levels for dog dander, cat dander, human seminal fluid, and latex, as determined using an ImmunoCAP system (Phadia, Uppsala, Sweden), were 13.00 UA/mL, 1.39UA/mL 1.02UA/mL, and 0.1 >UA/mL, respectively. A skin prick test was performed using seminal fluid from her husband. When the average wheal diameter induced by the allergen was >50% of the positive control response induced by histamine hydrochloride at 10 mg/ ml, the result was considered positive. The results were positive for 10and 100-fold diluted seminal fluid (wheal diameters, 6 6 and 6 5 mm, respectively; positive control [10 mg/ml histamine hydrochloride]: wheal diameter, 6 6 mm; negative control [saline]: wheal diameter, 0 0 mm). She developed cough and pruritic erythema on her thigh 15min after the prick test. Antihistamines were administered intravenously and the symptoms disappeared within 30 min. Next, seminal fluid from her husband was separated into spermatozoa and seminal plasma by a percol gradient technique, and the spermatozoa were washed three times with spermwash media. A skin prick test was performed using spermatozoa, seminal plasma, percol and

A case of human seminal plasma allergy sensitized with dog prostatic kallikrein, Can f 5