22
Management
VII. Seminal Fluid Anaphylaxis
Î SS 55: Diagnose seminal plasma anaphylaxis by skin testing with fresh
whole human seminal plasma or its fractions obtained from the male
partner. Exclude other underlying causes such as allergens in natural
rubber latex condoms or in drugs or foods passively transferred
through seminal plasma. (R-D)
Î SS 56: Treat patients with postcoital local reactions to human seminal
plasma with intravaginal graded challenge to dilutions of whole
seminal fluid or systemic desensitization to relevant seminal plasma
proteins. (R-C)
Î SS 57: Instruct women with systemic seminal plasma hypersensitivity
to have AIE readily available if barrier failure with condoms occurs.
(S-C)
Î SS 58: Perform intravaginal graded challenge with whole seminal
plasma of the male partner, recognizing that the duration of protection
is unknown, before pursing desensitization using relevant seminal
plasma protein fractions in any patient who is likely to have had an
IgE-mediated reaction to seminal plasma. (R-C)
Î SS 59: Perform desensitization using relevant seminal plasma protein
fractions in patients who are likely to have had an IgE-mediated
reaction to seminal plasma. (R-C)
Î SS 60: Inform patients with seminal plasma allergy that they might be
able to conceive by artificial insemination with washed spermatozoa
and that infertility does not appear to be linked to localized or
systemic seminal plasma hypersensitivity. (R-C)
VIII. Exercise-induced Anaphylaxis
Î SS 61: Recognize that some patients experience anaphylaxis only if
other cofactors are present in association with exercise. These "co-
triggers" include ingestion of foods (specific or general), NSAIDs,
especially aspirin, and, rarely, high pollen levels. (S-C)
Î SS 62: Avoid exercise in the immediate postprandial period especially
if exercise-induced anaphylaxis (EIA) episodes are associated with the
ingestion of food (food in general or a specific food). (S-C)
Î SS 63: Recognize that identification of potential co-triggers is a
critical component of the clinical history. Evaluate the patient for
sensitization to relevant food allergens (history driven). (R-C)
Î SS 64: Recognize that exercise challenge testing does not consistently
reproduce symptoms and is not a useful part of the evaluation. (R-C)
