48 hours after tuberculine test (Mantoux test) a child had a papule 10 mm in diameter on the spot of tuberculine injection. What hypersensitivity mechanism underlies these changes?

Answer options

1. Anaphylaxy
2. Immunocomplex cytotoxicity
3. Cellular cytotoxicity
4. Granulomatosis
5. Antibody-dependent cytotoxicity

Explanation

Type IV (Delayed hypersensitivity or Cell-mediated): contact dermatitis, Graft-versus-host disease, multiple sclerosis. The response is delayed and does not involve antibodies. Type I (immediate, anaphylactic, atopic): Allergic and atopic disorders (e.g. Rhinitis, hay fever, asthma); Anaphylaxis. Type II (Cytotoxic Reaction/Antibody-dependent): acute hemolytic transfusion reactions, autoimmune hemolytic anemia, Erythroblastosis details, good pasture syndrome, Gravis disease, Myasthenia gravis. The disease tends to be specific to the tissue or site where the antigen is found. Type III (Immune Complex Reaction): Arthus reaction, SLE, serum sickness, Rheumatoid Arthritis, Post-streptococcal glomerulonephritis, Polyarteritis nodosa, etc. Can be associated with vasculitis and systemic manifestation.