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Hypersensitivity Information

Hypersensitivity (also called hypersensitivity reaction) refers to undesirable reactions produced by the normal immune system. These reactions may be damaging, uncomfortable, or occasionally fatal. Hypersensitivity reactions require a pre-sensitized (immune) state of the host. The four-group classification was expounded by P. H. G. Gell and Robin Coombs in 1963.[1]

Contents

Coombs and Gell classification

Comparison of hypersensitivity types
Type Alternative names Often mentioned disorders Mediators
I Allergy (immediate)
II Cytotoxic, antibody-dependent
III Immune complex disease
IV Delayed-type hypersensitivity[2] [3](DTH), cell-mediated immune memory response, antibody-independent
V Autoimmune disease, receptor mediated (see below)

Type V

This is an additional type that is sometimes (often in Britain) used as a distinction from Type 2.[5]

Instead of binding to cell surface components, the antibodies recognize and bind to the cell surface receptors, which either prevents the intended ligand binding with the receptor or mimics the effects of the ligand, thus impairing cell signaling.

Some clinical examples:

The use of Type 5 is rare. These conditions are more frequently classified as Type 2, though sometimes they are specifically segregated into its own subcategory of Type 2.

References

  1. ^ Gell PGH, Coombs RRA, eds. Clinical Aspects of Immunology. 1st ed. Oxford, England: Blackwell; 1963.
  2. ^ Black, CA. Delayed Type Hypersensitivity: Current Theories with an Historic Perspective Dermatol. Online J. (May 1999) 5(1):7 at http://dermatology.cdlib.org/DOJvol5num1/reviews/black.html
  3. ^ http://emedicine.medscape.com/article/136118-overview
  4. ^ Table 5-1 in:Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson (2007). Robbins Basic Pathology. Philadelphia: Saunders. ISBN 1-4160-2973-7. 8th edition.
  5. ^ Rajan TV (July 2003). "The Gell-Coombs classification of hypersensitivity reactions: a re-interpretation". Trends Immunol. 24 (7): 376–9. doi:10.1016/S1471-4906(03)00142-X. PMID 12860528. http://linkinghub.elsevier.com/retrieve/pii/S147149060300142X.

External links

· · Pathology: Medical conditions and ICD code
(Disease / Disorder / Illness, Syndrome / Sequence, Symptom / Sign, Injury, etc.)
(A/B, 001–139) Infectious disease/Infection: Bacterial disease (G+, G-) · Virus disease · Parasitic disease (Protozoan infection, Helminthiasis, Ectoparasitic infestation) · Mycosis · Zoonosis
(C/D, 140–239 & 279–289)
Cancer (C00–D48, 140–239) Tumor
Myeloid hematologic (D50–D77, 280–289) Anemia · Coagulopathy
Lymphoid immune (D80–D89, 279) Immunodeficiency · Immunoproliferative disorder · Hypersensitivity
(E, 240–278) Endocrine disease · Nutrition disorder · Inborn error of metabolism
(F, 290–319) Mental disorder
(G, 320–359) Nervous system disease (CNS, PNS) · Neuromuscular disease
(H, 360–389) Eye disease · Ear disease
(I, 390–459) Cardiovascular disease (Heart disease, Vascular disease)
(J, 460–519) Respiratory disease (Obstructive lung disease, Restrictive lung disease, Pneumonia)
(K, 520–579) Stomatognathic disease (Tooth disease) · Digestive disease (Esophageal, Stomach, Enteropathy, Liver, Pancreatic)
(L, 680–709) Skin disease · skin appendages (Nail disease, Hair disease, Sweat gland disease)
(M, 710–739) Musculoskeletal disorders: Myopathy · Arthropathy · Osteochondropathy (Osteopathy, Chondropathy)
(N, 580–629) Urologic disease (Nephropathy, Urinary bladder disease) · Male genital disease · Breast disease · Female genital disease
(O, 630–679) Complications of pregnancy · Obstetric labor complication · Puerperal disorder
(P, 760–779) Fetal disease
(Q, 740–759) Congenital disorder (Congenital abnormality)
(R, 780–799) Syndromes · Medical signs (Eponymous)
(S/T, 800–999) Bone fracture · Joint dislocation · Sprain · Strain · Subluxation · Head injury · Chest trauma · Poisoning
· · Consequences of external causes (T66–T78, 990–995)
Temperature/radiation elevated temperature: Hyperthermia · Heat syncope reduced temperature: Hypothermia · Immersion foot syndromes (Trench foot • Tropical immersion foot • Warm water immersion foot) · Chilblains · Frostbite · Cold intolerance • Acrocyanosis • Erythrocyanosis crurum radiation: Radiation poisoning · Radiation burn · Chronic radiation keratosis • Eosinophilic, polymorphic, and pruritic eruption associated with radiotherapy • Radiation acne • Radiation cancer • Radiation recall reaction • Radiation-induced erythema multiforme • Radiation-induced hypertrophic scar • Radiation-induced keloid • Radiation-induced morphea
Air Hypoxia/Asphyxia · Barotrauma (Aerosinusitis, Decompression sickness) · High altitude (Altitude sickness/Chronic mountain sickness, HAPE)
Food Starvation
Maltreatment Physical abuse · Sexual abuse · Psychological abuse
Emesis Motion sickness · Seasickness · Airsickness · Space adaptation syndrome
Adverse effect Hypersensitivity (Anaphylaxis, Angioedema, Allergy, Arthus reaction) Adverse drug reaction
Other Electric shock · Drowning · Lightning injury
Ungrouped skin conditions resulting from physical factors Dermatosis neglecta • Pinch mark • Pseudoverrucous papules and nodules • Sclerosing lymphangiitis • Tropical anhidrotic asthenia • UV-sensitive syndrome

environmental skin conditions: Electrical burn • frictional/traumatic/sports (Black heel and palm • Equestrian perniosis • Jogger's nipple • Pulling boat hands • Runner's rump • Surfer's knots • Tennis toe • Vibration white finger • Weathering nodule of ear • Wrestler's ear • Coral cut • Painful fat herniation ) • Uranium dermatosis

iv use (Skin pop scar • Skin track • Slap mark • Pseudoacanthosis nigricans • Narcotic dermopathy)
· · Immune disorders: Lymphoid and complement immunodeficiency (D80–D85, 279.0–4)
Primary
Antibody/humoral (B)
Hypogammaglobulinemia X-linked agammaglobulinemia · Transient hypogammaglobulinemia of infancy
Dysgammaglobulinemia IgA deficiency · IgG deficiency · IgM deficiency · Hyper IgM syndrome (2, 3, 4, 5) · Wiskott-Aldrich syndrome · Hyper-IgE syndrome
Other Common variable immunodeficiency · ICF syndrome
T cell deficiency (T) thymic hypoplasia: hypoparathyroid (Di George's syndrome) · euparathyroid (Nezelof syndrome, Ataxia telangiectasia) peripheral: Purine nucleoside phosphorylase deficiency · Hyper IgM syndrome (1)
Severe combined (B+T) x-linked: X-SCID autosomal: Adenosine deaminase deficiency · Omenn syndrome · ZAP70 deficiency · Bare lymphocyte syndrome
Acquired AIDS
Leukopenia: Lymphocytopenia Idiopathic CD4+ lymphocytopenia
Complement deficiency C1-inhibitor (Angioedema/Hereditary angioedema) · Complement 2 deficiency/Complement 4 deficiency · MBL deficiency · Properdin deficiency · Complement 3 deficiency · Terminal complement pathway deficiency · Paroxysmal nocturnal hemoglobinuria · Complement receptor deficiency

: LMC

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, drug(/)
· · Immune disorders: hypersensitivity and autoimmune diseases (279.5–6)
Type I/allergy/atopy (IgE)
Foreign Atopic dermatitis · Allergic urticaria · Hay fever · Allergic asthma · Anaphylaxis · Food allergy (Milk, Egg, Peanut, Tree nut, Seafood, Soy, Wheat), Penicillin allergy
Autoimmune none
Type II/ADCC (IgM, IgG)
Foreign Pernicious anemia · Hemolytic disease of the newborn
Autoimmune
Cytotoxic Autoimmune hemolytic anemia · Idiopathic thrombocytopenic purpura · Bullous pemphigoid · Pemphigus vulgaris · Rheumatic fever · Goodpasture's syndrome
"Type 5"/receptor Graves' disease · Myasthenia gravis
Type III (Immune complex)
Foreign Henoch–Schönlein purpura · Hypersensitivity vasculitis · Reactive arthritis · Rheumatoid arthritis · Farmer's lung · Post-streptococcal glomerulonephritis · Serum sickness · Arthus reaction
Autoimmune Systemic lupus erythematosus · Subacute bacterial endocarditis
Type IV/cell-mediated (T-cells)
Foreign Allergic contact dermatitis · Mantoux test
Autoimmune Diabetes mellitus type 1 · Hashimoto's thyroiditis · Guillain–Barré syndrome · Multiple sclerosis · Coeliac disease · Giant-cell arteritis
GVHD Transfusion-associated graft versus host disease
Unknown/ multiple
Foreign Hypersensitivity pneumonitis (Allergic bronchopulmonary aspergillosis) · Transplant rejection · Latex allergy (I+IV)
Autoimmune Sjögren's syndrome · Autoimmune hepatitis · Autoimmune polyendocrine syndrome (APS1, APS2) · Autoimmune adrenalitis · Systemic autoimmune disease

: LMC

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, drug(/)

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