Q: In which allergy Protamine should be given with caution?

Answer: Protamine was originally isolated from the sperm of salmon and other species of fish but is now produced primarily through recombinant biotechnology. The patients who are considered to be most at risk for a reaction to protamine are those with

• An allergy to fish
• Prior protamine exposure
• Vasectomy

Note: There is a distinct genetic difference between shellfish and vertebrate fish, so, an allergy to shellfish does not predispose one to an adverse protamine reaction.




Further reading:

1. Collins and A O'Donnell - Perfusion 2008 23: 369 Does an allergy to fish pre-empt an adverse protamine reaction? A case report and a literature review

2. Watson RA, Ansbacher R, Barry M, Deshon GE Jr, Agee RE - Allergic reaction to protamine: a late complication of elective vasectomy? - Urology. 1983 Nov;22(5):493-5.