Anaphylactic reaction after artificial insemination.
BACKGROUND
Bovine seroalbumin is known as an allergen for human beings, but reactions to it in an artificial insemination procedure are much rarer. We report a case of anaphylaxis after intrauterine insemination (IUI) in which sensitization to bovine serum albumin (BSA) is demonstrated.


OBJECTIVE
Report the allergy evaluation performed in a patient who suffered a severe reaction immediately after an IUI procedure.


METHODS
A 33-year-old woman was referred because of an anaphylactic reaction after a second trial of IUI. She developed pruritus, abdominal pain, nausea and vomiting, bronchospasm, and generalized urticaria. She had an atopic medical history of pollen allergy and sensitization to cat epithelium. She had never had trouble with minor surgery and she usually uses latex material. She had never received heterologous sera before. Her husband's semen for the IUI was processed in a standard fluid medium called upgraded INRA B 2 (Laboratoires CCD, Paris, France), which contains amino acids, lipids, vitamins, BSA, penicillin, and streptomycin in addition to inorganic salts.


RESULTS
Skin prick tests with the medium and BSA 10 mg/mL were positive. In vitro studies demonstrated an immunoglobulin E binding protein of 60 to 65 kDa and mast cells and basophil activation (CD63 expression) against BSA contained in the medium. Cutaneous and challenge tests with penicillin and streptomycin were negative.


CONCLUSIONS
We consider the BSA in the semen culture medium to be the factor which triggered the anaphylactic reaction. This case supports the authors who state that media free from heterologous proteins should be used for human application, especially on atopic patients, to avoid sensitization.
Centro Médico de Alergia y Asma de Pamplona, Pamplona, Spain. MOrta@imqnavarra.com
Marta
M
Orta
Elena
E
Ordoqui
Ascensión
A
Aranzábal
Cristina
C
Fernández
Borja
B
Bartolomé
Maria Luisa
ML
Sanz
D000328:Adult; D000485:Allergens; D000707:Anaphylaxis / Q000209:etiology*; D000818:Animals; D015549:Basophil Degranulation Test; D002417:Cattle; D003429:Cross Reactions; D003470:Culture Media / Q000009:adverse effects*; D005260:Female; D006636:Histamine Release; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications; D007114:Immunization; D007073:Immunoglobulin E / Q000276:immunology; D007317:Insemination, Artificial, Homologous / Q000009:adverse effects*; D008407:Mast Cells / Q000276:immunology; D012709:Serum Albumin / Q000276:immunology; D012710:Serum Albumin, Bovine / Q000009:adverse effects* / Q000276:immunology; D012756:Sheep; D016037:Single-Blind Method; D012882:Skin Tests; D013045:Species Specificity; D013552:Swine
D000485:Allergens; D003470:Culture Media; D012709:Serum Albumin; D012710:Serum Albumin, Bovine; D007073:Immunoglobulin E