Hypersensitivity and Autoimmunity · USMLE Step 1

Patients with multiple sclerosis develop demyelination due to autoimmunity. What is the primary mechanism?

  1. Type I IgE reaction
  2. Type II antibody-dependent cytotoxicity
  3. Type III immune complex disease
  4. Type IV T-cell–mediated destruction
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Correct answer: Type IV T-cell–mediated destruction

MS involves T-cell–mediated destruction of oligodendrocytes. This categorizes it as a Type IV reaction.

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