Description
A 36 year old lady was referred to the Immunology Clinic three months after two admissions to A E during a six month period with attacks of severe sneezing, burning ears and throat, swollen eyes and wheezing. These occurred in the early hours of the morning, after drinking beer, within minutes of sexual intercourse, and 2-3 days prior to the onset of her period. No food was ingested although the patient was on a course of doxycycline during the first episode. Best peak flows at the time were 310 and 340 l/min respectively, with her normal being 450 l/min. Sexual intercourse, and ingestion of beer and nuts, had taken place on several occasions since without symptoms. She also described episodes of wheals occurring when semen came into contact with her skin.
