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Hypersensitivity Reactions: Delayed Hypersensitivity Reactions

Hypersensitivity Reactions: Delayed Hypersensitivity Reactions

Delayed-Type Hypersensitivity (DTH), or Type IV hypersensitivity, is a cell-mediated immune response. It occurs when T cells, rather than antibodies, mediate a reaction to specific antigens. It is characterized by a delayed onset (1-2 days) and involves the recruitment of macrophages to the inflammation site.The initiation of a DTH response begins with the sensitization of T cells. During this phase, which lasts at least 1-2 weeks, antigen-specific T cells are activated, clonally expanded, and...

Hypersensitivities

Hypersensitivities

Hypersensitivity, also known as a hypersensitivity reaction or allergic reaction, is a condition where the body's immune system reacts abnormally to a foreign substance. Such substances, that cause hypersensitivity are referred to as an allergen, could be something typically harmless to most people, like pollen or certain foods.
Types of Hypersensitivities
Hypersensitivity reactions are categorized into four types: Type 1, Type 2, Type 3, and Type 4. Each type has a distinct mechanism...

Drug Toxicity: Allergic Reactions

Drug Toxicity: Allergic Reactions

Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial...

Allergic Drug Reactions

Allergic Drug Reactions

Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...

Hypersensitivity Reactions: Immune-Complex Reactions

Hypersensitivity Reactions: Immune-Complex Reactions

Type III hypersensitivity reactions occur when antigen–antibody complexes form and activate the complement system. Normally, these complexes help the clearance of antigens by phagocytes and red blood cells. However, when large numbers of immune complexes are present, they can deposit in tissues—particularly in the walls of blood vessels—leading to inflammation and tissue injury. These deposits trigger complement activation and neutrophil recruitment, resulting in serum...

Hypersensitivity Reactions: Cytolytic Reactions

Hypersensitivity Reactions: Cytolytic Reactions

Type II hypersensitivity involves IgG and IgM antibodies targeting cell surface antigens, leading to cell destruction. This can occur through complement activation, antibody-dependent cell-mediated cytotoxicity (ADCC), or acting as opsonins for phagocytosis. When excessive, these reactions cause significant tissue damage.Drug-induced hemolytic anemia is a common example, where drugs like penicillin or cephalosporins bind to red blood cells, forming drug-protein complexes. These complexes...

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Related Experiment Video

Updated: Feb 23, 2026

Basophil Activation Test for Investigation of IgE-Mediated Mechanisms in Drug Hypersensitivity

Basophil Activation Test for Investigation of IgE-Mediated Mechanisms in Drug Hypersensitivity

Published on: September 16, 2011

Evaluation of periprocedural hypersensitivity reactions.

Melissa Iammatteo¹, Taha Keskin¹, Elina Jerschow¹

¹Division of Allergy and Immunology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology

|September 4, 2017

Summary

Identifying the cause of periprocedural hypersensitivity reactions (HSRs) is difficult. In this study, induction agents were the most common cause, differing from prior research, highlighting the need for standardized evaluation guidelines.

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Last Updated: Feb 23, 2026

Basophil Activation Test for Investigation of IgE-Mediated Mechanisms in Drug Hypersensitivity

Basophil Activation Test for Investigation of IgE-Mediated Mechanisms in Drug Hypersensitivity

Published on: September 16, 2011

Measuring Local Anaphylaxis in Mice

Measuring Local Anaphylaxis in Mice

Published on: October 14, 2014

Contact Hypersensitivity as a Murine Model of Allergic Contact Dermatitis

Contact Hypersensitivity as a Murine Model of Allergic Contact Dermatitis

Published on: September 26, 2022

Area of Science:

Anesthesiology
Allergy and Immunology
Pharmacology

Background:

Periprocedural hypersensitivity reactions (HSRs) pose diagnostic challenges due to numerous potential causative medications.
Antibiotics are frequently implicated in the US, while neuromuscular blocking agents are more common in Europe.

Purpose of the Study:

To identify the specific causative agents responsible for periprocedural HSRs.

Main Methods:

A 7-year retrospective review of medical records from a drug allergy center.
Evaluation included patient demographics, historical HSRs, and results of skin testing for suspected medications.
Reviewed tolerance of subsequent anesthesia in patients who underwent further procedures.

Main Results:

Skin testing identified IgE-mediated causes in 64.7% of evaluated patients.
Induction agents were the most common causative class (36%), with midazolam frequently implicated.
Cefazolin (32%) and ondansetron (12%) were the most common individual agents identified.

Conclusions:

Induction agents were the primary cause of periprocedural HSRs in this patient cohort, contrasting with previous findings.
Variability in evaluation methods and small sample sizes necessitate national guidelines and a registry for standardized HSR assessment.