Hypersensitivity

Hypersensitivity
Classification and external resources
ICD-10	T78.4
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]

1 Coombs and Gell classification
2 Type 5
3 References
4 External links

Coombs and Gell classification

**Comparison of hypersensitivity types**
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^[2] (DTH), cell-mediated immune memory response, antibody-independent	Contact dermatitis Mantoux test Chronic transplant rejection Multiple sclerosis ^[3]	T-cells
V	Autoimmune disease, receptor mediated (see below)	Grave's disease Myasthenia Gravis	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.^[4]

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.
↑ 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

Hypersensitivity definition, types, causes, and general details
Hypersensitivity reactions at GPnotebook

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 · Heat intolerance reduced temperature: Hypothermia · Immersion foot · Chilblain · Frostbite · Cold intolerance radiation: Radiation poisoning · Radiation burn

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	Abrasion • Acrocyanosis • Actinic prurigo • Benign summer light eruption • Beryllium granuloma • Black heel and palm • Callus • Carbon stain • Chilblains • Chronic actinic dermatitis • Colloid milium • Coma blister • Coral cut • Delayed blister • Dermatosis neglecta • Edema blister • Electrical burn • Equestrian perniosis • Erythema ab igne • Erythrocyanosis crurum • Favre–Racouchot syndrome • Foreign body reaction • Fracture blister • Friction blister • Frostbite • Hot tar burn • Hydroa vacciniforme • Jogger's nipple • Juvenile spring eruption • Kairo cancer • Kang cancer • Kangri ulcer • Mercury granuloma • Miliaria crystalline • Miliaria profunda • Miliaria pustulosa • Miliaria rubra • Narcotic dermopathy • Occlusion miliaria • Painful fat herniation • Peat fire cancer • Photoaging • Photosensitivity with HIV infection • Phototoxic tar dermatitis • Phytophotodermatitis • Pinch mark • Polymorphous light eruption • Postmiliarial hypohidrosis • Pressure ulcer • Pseudoacanthosis nigricans • Pseudoverrucous papules and nodules • Pulling boat hands • PUVA-induced acrobullous dermatosis • Runner's rump • Sclerosing lymphangiitis • Silica granuloma • Silicone granuloma • Skin pop scar • Skin track • Slap mark • Solar erythema • Soot tattoo • Subcutaneous emphysema • Sucking blister • Sunburn • Surfer's knots • Tattoo • Tennis toe • Thermal burn • Traumatic asphyxia • Trench foot • Tropical anhidrotic asthenia • Tropical immersion foot • Turf toe • Uranium dermatosis • UV-sensitive syndrome • Vibration white finger • Warm water immersion foot • Weathering nodule of ear • Wrestler's ear • Zirconium granuloma Ionizing radiation-induced: Acute radiodermatitis • Chronic radiation keratosis • Chronic radiodermatitis • Eosinophilic, polymorphic, and pruritic eruption associated with radiotherapy • Radiation acne • Radiation cancer • Radiation dermatitis • Radiation recall reaction • Radiation-induced erythema multiforme • Radiation-induced hypertrophic scar • Radiation-induced keloid • Radiation-induced morphea

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

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

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

cell/phys/auag/auab/comp,imrc,tcrp

imdf/ipig/hyps/tumr

proc, drug(/4)

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