Hypersensitivity: Wikis

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This article is about the medical condition. For the music album, see Hypersensitive.

Hypersensitivity
Classification and external resources
ICD-10	T 78.4
ICD-9	995.3
DiseasesDB	28827
MeSH	D006967

Hypersensitivity (also called hypersensitivity reaction) refers to undesirable (damaging, discomfort-producing and sometimes fatal) reactions produced by the normal immune system. 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]

Coombs and Gell classification

**Comparison of hypersensitivity types**^[2]
Type	Alternative names	Often mentioned disorders	Mediators
I	Allergy (immediate)	Atopy Anaphylaxis Asthma	IgE
II	Cytotoxic, antibody-dependent	Autoimmune hemolytic anemia Thrombocytopenia Erythroblastosis fetalis Goodpasture's syndrome	IgM or IgG (Complement)
III	Immune complex disease	Serum sickness Arthus reaction Systemic lupus erythematosus (SLE)	IgG (Complement)
IV	Delayed-type hypersensitivity^[3] (DTH), cell-mediated immune memory response, antibody-independent	Contact dermatitis Mantoux test Chronic transplant rejection Multiple sclerosis ^[4]	T-cells
V	Autoimmune disease	Grave's disease Myasthenia Gravis Hashimoto's thyroiditis Systemic lupus erythematosus	IgM or IgG (Complement)

Type 5

Main article: Type V hypersensitivity reaction

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

^ Gell PGH, Coombs RRA, eds. Clinical Aspects of Immunology. 1st ed. Oxford, England: Blackwell; 1963.
^ Unless else specified in boxes, then ref is: Lippincott's Illustrated Reviews: Immunology. Paperback: 384 pages. Publisher: Lippincott Williams & Wilkins; (July 1, 2007). Language: English. ISBN 0781795435. ISBN 978-0781795432. Page 195
^ 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
^ 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.
^ 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 (Diseases/Disorders/Illness, Syndromes/Sequences, Symptoms/Signs, Injuries, etc.) and ICD codes

(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 & 280-289)

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 · 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

(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-T88, 990-999)

Temperature/radiation	elevated: Hyperthermia · Heat syncope · Radiation poisoning reduced: Hypothermia · Immersion foot · Chilblain

Air	Hypoxia/Asphyxia · Barotrauma (Aerosinusitis, Decompression sickness) · Altitude sickness/Chronic mountain sickness

Food	Starvation

Maltreatment	Physical abuse · Sexual abuse · Psychological abuse

Emesis	Motion sickness · Seasickness · Airsickness · Space adaptation syndrome

Other	Electric shock · Anaphylaxis · Angioedema Hypersensitivity (Allergy, Arthus reaction) Subcutaneous emphysema

Certain early complications of trauma	embolism (Air, Fat) Crush syndrome/Rhabdomyolysis Contracture/Volkmann's contracture/Compartment syndrome

Complications of surgical and medical care	transfusion reactions: Transfusion hemosiderosis · TRALI · TACO · TA-GvHD · FNHTR · Acute/Delayed hemolytic transfusion reaction other: Serum sickness · Malignant hyperthermia · Herxheimer reaction · Graft-versus-host disease · Tumor lysis syndrome

Immune disorders: Lymphoid and complement immunodeficiency (D80-D85, 279)

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

Cell-mediated (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

Lymphocytopenia

Idiopathic CD4+ lymphocytopenia

Complement deficiency

C1-inhibitor (Angioedema/Hereditary angioedema) · Complement 2 deficiency

lymphocyte navs: cells/physio, immunodeficiency/immunoproliferative immunoglobulin/neoplasia, proc

Immune disorders: hypersensitivity and autoimmune diseases

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	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

lymphocyte navs: cells/physio, immunodeficiency/immunoproliferative immunoglobulin/neoplasia, proc

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