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Hypersensitivity- type II

Group 1
Mary Kimberly Dimla
Mark Jadrian Partolan
March Tracy Salinas
Kristensen Torres
Type II hypersensitivity reactions or cytotoxic reactions
are caused by IgG or IgM antibodies against cell surface
and extracellular matrix antigen.

This binding of antigen and antibody can result in

complement and destruction of the cell to which the
antigen is bound.

Examples includes immediate transfusion reactions and

immune hemolytic anemias such as hemolytic disease of
the newborn.
Transfusion Reaction
Transfusion reactions to erythrocytes

These are produced by antibodies to blood group

antigens, which may occur naturally or may have
been included by previous contact with
incompatible tissue or blood following
transplantation, transfusion or during pregnancy.
Several factors that influences whether a
transfusion reaction will be acute or delayed:

1. The number of incompatible erythrocytes

2. The antibody or subclass.
3. The achievement of the optimal temperature
for antibody binding.
Types of Transfusion
Immediate Hemolytic Reactions
The most common cause of an acute hemolytic
transfusion reaction of ABO- group incompatible blood.

Epidemiology. Acute hemolytic rection are the most serious and

potentially lethal.

Signs and symptoms. Reactions can occur with infusion of a

10 to 15 ml of incompatible blood. Common symptoms includes
fever and chills, back pain, shortness of breath, and
Immunologic manifestation. Acute hemolytic reaction occur
during or immediately after blood has been infused.

Delayed Hemolytic
A delayed reaction may not express itself until 7 to 10 days post
transfusion. These reactions are associated with decreased red
cell survival because of the coating of the red cells ( a positive

Delayed reactions maybe of two types. It may represent an

anamnestic antibody response in a previously immunized recipient
upon secondary exposure to transfused erythrocyte, or it may
result to primary alloimmunization.
Hemolytic Disease of the Newborn ( HDN)
Results from excessive destruction of fetal red cells by
maternal antibodies.
This condition in fetus is clinically characterized by
anemia an jaundice.

Etiology. Antigens possessed by the fetus that are foreign to

the mother can provoke an antibody response in the mother.
Any blood group antigen that occurs as an IgG antibody is
capable of causing HDN.

Signs and symptoms. HDN resulting from ABO

incompatibility is usually mild in manifestations because of
several factors (fewer A and B antigens sites on the fetal
RBCs, weaker antigen strength of fetal A and B antigens,
and competition for anti A and anti b bet. tissues and
Immunologic mechanism. For antibody formation to take place,
the mother must lack the antigen, and the fetus must express the
antigen (gene product).
Transplacental Hemorrhage (TPH) can occur at any stage of
pregnancy. Immunization resulting from TPH can result from
negligible doses during the first 6 months in the utero.
Immune antibodies subsequently react with fetal antigens.
Erythrocytic antigens as well as leukocyte and platelets can
induce maternal immunization by the formation of IgG antibodies.
Diagnostic evaluation. The following procedures are
generally employed in either the prenatal or postnatal
diagnosti evaluation of HDN:
1. ABO blood group
2. Rh testing
3. Screening for alloantibodies
4. Amniocentesis
5. Serum bilirubin of cord or infant blood
6. Direct antiglobulin test of cord or infant blood
7. Peripheral blood smear
8. The Du rosete or Kleihauer-Betke test
Immediate non-hemolytic
• Febrile reactions
• Anaphylaxis
• Urticaria
• Noncardiac pulmonary edema
• Fever and shock
• Congestive heart failure
• Myocardial failure
Delayed non-hemolytic
• Graft-vs-host disease
• Posttransfusion purpura
• Iron overload
• Alloimmunization to erythrocytes,
leukocytes, and platelets antigens
• Infectious diseases