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Autoimmune progesterone anaphylaxis.

Mohammad Hassan Bemanian¹, Mohammad Gharagozlou, Mohammad Hossein Farashahi

¹Department of Pediatrics, Shahid Sadoughi Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. mhbemanian@razi.tums.ac.ir

Iranian Journal of Allergy, Asthma, and Immunology

|June 15, 2007

Summary

Autoimmune progesterone anaphylaxis (AIPA) is a rare condition causing cyclic skin and respiratory symptoms in females. Diagnosis involves a progesterone skin test, and treatment with estrogen therapy proved effective in this case.

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Area of Science:

Immunology
Dermatology
Endocrinology

Background:

Autoimmune progesterone dermatitis is a rare disorder triggered by endogenous or exogenous progesterone.
It typically manifests as cyclic skin eruptions, often in the luteal phase of the menstrual cycle.

Observation:

A case of autoimmune progesterone anaphylaxis (AIPA) in an 18-year-old female presenting with cyclic dyspnea, cough, and skin eruptions prior to menses.
Symptoms were linked to endogenous progesterone production, with no prior exogenous hormone use.

Findings:

Diagnosis of AIPA was confirmed via intradermal skin testing with progesterone, showing a positive wheal and flare reaction.
Continuous oral conjugated estrogen therapy (0.625 mg) successfully resolved both dermatologic and respiratory symptoms.

Implications:

This case highlights AIPA as a distinct entity from progesterone dermatitis when systemic symptoms like respiratory distress are present.
Estrogen therapy may be an effective treatment for managing AIPA by suppressing ovulation and endogenous progesterone production.
Further research is warranted to understand the immunopathogenesis and optimize management strategies for AIPA.