What are the 4 types of hypersensitivity reactions?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 24, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

The four types of hypersensitivity reactions are Type I, Type II, Type III, and Type IV, as classified by Gell and Coombs, with distinct mechanisms and examples, including anaphylaxis, haemolytic anaemia, serum sickness, and allergic contact dermatitis, respectively. These reactions can be described as follows:

  • Type I: IgE antibody-mediated reactions, such as anaphylaxis, which can be life-threatening and require immediate medical attention 1.
  • Type II: Antibody-mediated cytotoxic reactions, including haemolytic anaemia and thrombocytopaenia, which can lead to significant morbidity and mortality if not properly managed 1.
  • Type III: Immune complex-mediated hypersensitivity, exemplified by serum sickness and vasculitis, which can cause significant inflammation and tissue damage 1.
  • Type IV: Delayed T cell-mediated responses, such as allergic contact dermatitis and psoriasis, which can impact quality of life and require ongoing management 1. It is essential to understand these different types of hypersensitivity reactions to provide appropriate diagnosis and treatment, minimizing morbidity, mortality, and improving quality of life 1.

From the Research

Hypersensitivity Reactions

The four types of hypersensitivity reactions are:

  • Type I: immediate or IgE mediated 2, 3
  • Type II: cytotoxic or IgG/IgM mediated, which can be further divided into type IIa and type IIb 2
  • Type III: IgG/IgM immune complex mediated 2, 3
  • Type IV: delayed-type hypersensitivity or T-cell mediated, which can be further divided into four categories: type IVa, type IVb, type IVc, and type IVd 2

Subcategories of Type IV Hypersensitivity Reactions

The subcategories of type IV hypersensitivity reactions are:

  • Type IVa: CD4(+)Th1 lymphocyte mediated with activation of macrophages 2
  • Type IVb: CD4(+)Th2 lymphocyte mediated with eosinophilic involvement 2
  • Type IVc: cytotoxic CD8(+) T lymphocyte with involvement of perforin-granzme B in apoptosis 2
  • Type IVd: T-lymphocyte-driven neutrophilic inflammation 2

Clinical Significance

These hypersensitivity reactions can occur simultaneously in some diseases, making diagnosis and treatment challenging 3. Understanding the different types of hypersensitivity reactions is essential for improved diagnostics and therapeutic interventions 3, 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Chapter 28: Classification of hypersensitivity reactions.

Allergy and asthma proceedings, 2012

Research

Allergy: Type I, II, III, and IV.

Handbook of experimental pharmacology, 2022

Research

Classification of hypersensitivity reactions.

Allergy and asthma proceedings, 2019

Related Questions

What are the different types of hypersensitivities?
What is the prevalence of autoimmune hemolytic anemia (AIHA) in patients with lupus nephritis?
What type of hypersensitivity reaction is characterized by symptoms of cough, joint pain, and breathlessness that resolve and then recur after 6 months, involving the formation of immune complexes?
Can systemic lupus erythematosus (SLE) cause hemolytic anemia?
What is the logical explanation for the physiological decision to activate a type 1, type 2, type 3, or type 4 hypersensitivity response?
Are subcutaneous defibrillators (SCD) contraindicated after uterine fibroid embolization?
What is the diagnosis for a patient with tachycardia (heart rate 123), hypertension (blood pressure 139/89), leukocytosis (White Blood Cell (WBC) count 12.1), hypokalemia (Potassium 3.0), metabolic acidosis (carbon dioxide (CO2) 19), and hyperproteinemia (total protein 8.7) with normal albumin (5.3)?
What is the treatment for a patient with tachycardia (heart rate 123), hypertension (blood pressure 139/89), leukocytosis (White Blood Cell (WBC) count 12.1), hypokalemia (Potassium 3.0), metabolic acidosis (carbon dioxide (CO2) 19), and hyperproteinemia (total protein 8.7) with normal albumin (5.3) levels?
What is the target milligram per kilogram (mg/kg) dose of isotretinoin?
What is the prognosis for a 67-year-old patient with diabetes (diabetes mellitus) and debilitating back pain due to epidural lipomatosis without surgical intervention?
What postoperative analgesia options are available for a patient with allergies to tapentadol, oxycodone (OxyNorm)/naloxone, and pethidine (Meperidine)?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.