Table 5.

Specific Metals Associated with Different Presentations of Systemic Hypersensitivity.

	Hypersensitivity Mechanism
	Type I		Type IV
Metal	Chronic Urticaria Syndrome	Anaphylaxis	Systemic Sensitization/Metallosis	Systemic ACD	Airborne ACD
Aluminum			(Exley et al. 2009)
Barium		(Janower 1986)
Beryllium					(Dooms-Goossens et al. 1986)
Chromium	(Moller et al. 1986)	(Moller et al. 1986)	(Borowska and Brzoska 2015)	(Pigatto et al. 2014; Yoshihisa and Shimizu 2012)	(Dooms-Goossens et al. 1986)
Cobalt	(Mikhailova et al. 2017)	(Krecisz et al. 2009)	(Summer et al. 2007)	(Kimyon and Warshaw 2019)	(Kimyon and Warshaw 2019)
Copper	(Mikhailova et al. 2017)
Gadolinium	(Jung et al. 2012)	(Jung et al. 2012; Rodriguez-Nava et al. 2019)	(Jung et al. 2012; Lattanzio and Imbesi 2020)
Gold	(Mikhailova et al. 2017)		(Evans et al. 1987)	(Pigatto et al. 2014; Watsky 2007)	(Kimyon and Warshaw 2019)
Iridium		(Bergman, Svedberg, and Nilsson 1995)
Iron		(Rampton et al. 2014)
Magnesium		(Thorp et al. 1989)
Manganese			(Watchmaker, Collins, and Chaney 2015)
Mercury	(Barranco Sanz et al. 1989)	(Barranco Sanz et al. 1989; Pelaez Hernandez et al. 1994)		(Veien et al. 1994)	(Dooms-Goossens et al. 1986)
Molybdenum			(Summer et al. 2007)
Nickel	(Antico and Soana 1999; Abeck et al. 1993)	(Antico and Soana 1999; Antico and Soana 2015)	(Summer et al. 2007)	(Yoshihisa and Shimizu 2012)	(Kimyon and Warshaw 2019)
Palladium	(Pesonen et al. 2014)			(Hanafusa et al. 2012)
Platinum	(Makrilia et al. 2010)	(Makrilia et al. 2010)		(Makrilia et al. 2010)
Silver					(Dooms-Goossens et al. 1986)
Tin					(Quenan et al. 2014)
Titanium			(Peters et al. 1984)
Vanadium			(Engelhart and Segal 2017)
Zinc				(Sakai, Hatano, and Fujiwara 2013; Yoshihisa and Shimizu 2012)
Zirconium				(Teo and Schalock 2016)

Table 5: Metals implicated in different forms of systemic allergy. Common systemic presentations of metal allergy are listed in the table above. Responses are grouped by primary mechanism of hypersensitivity and specific metals implicated in each disease variant are denoted by the parenthesized numbers within the assoicated column, which correspond to relevant citations.