Allergy Unit, Hospital Universitario La Paz, Madrid, Spain.
Institute for Health Research (IdiPAZ), Madrid, Spain.
J Investig Allergol Clin Immunol. 2020;30(4):229-253. doi: 10.18176/jiaci.0480. Epub 2020 Jan 14.
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a complex multisystemic severe drug hypersensitivity reaction whose diagnosis and management are troublesome. DRESS syndrome requires management by various specialists. The correct identification of the culprit drug is essential to ensure safe future therapeutic options for the patient. There are no previous Spanish guidelines or consensus statements on DRESS syndrome. Objective: To draft a review and guidelines on the clinical diagnosis, allergy work-up, management, treatment, and prevention of DRESS syndrome in light of currently available scientific evidence and the experience of experts from multiple disciplines.
These guidelines were drafted by a panel of allergy specialists from the Drug Allergy Committee of the Spanish Society of Allergy and Clinical Immunology (SEAIC), together with other medical specialists involved in the management of DRESS syndrome and researchers from the PIELenRed consortium. A review was conducted of scientific papers on DRESS syndrome, and the expert panel evaluated the quality of the evidence of the literature and provided grades of recommendation. Whenever evidence was lacking, a consensus was reached among the experts.
The first Spanish guidelines on DRESS syndrome are now being published. Important aspects have been addressed, including practical recommendations about clinical diagnosis, identification of the culprit drug through the Spanish pharmacovigilance system algorithm, and the allergy work-up. Recommendations are provided on management, treatment, and prevention. Algorithms for the management of DRESS in the acute and recovery phases have been drawn up. Expert consensus-based stepwise guidelines for the management and treatment of DRESS syndrome are provided.
药物反应伴嗜酸性粒细胞增多和全身症状（DRESS）综合征是一种复杂的多系统严重药物超敏反应，其诊断和管理较为棘手。DRESS 综合征需要多学科专家进行管理。正确识别致敏药物对于确保患者未来的治疗安全至关重要。西班牙此前没有关于 DRESS 综合征的指南或共识声明。目的：根据现有的科学证据和来自多个学科的专家经验，制定关于 DRESS 综合征的临床诊断、过敏检查、管理、治疗和预防的综述和指南。
这些指南由西班牙过敏和临床免疫学学会（SEAIC）药物过敏委员会的过敏专家小组与参与 DRESS 综合征管理的其他医学专家以及 PIELenRed 联盟的研究人员共同制定。对 DRESS 综合征的科学文献进行了综述，专家小组评估了文献证据的质量并提供了推荐等级。在缺乏证据的情况下，专家们达成了共识。
现首次发布西班牙 DRESS 综合征指南。涵盖了重要方面，包括临床诊断的实用建议、通过西班牙药物警戒系统算法识别致敏药物以及过敏检查。提供了管理、治疗和预防方面的建议。制定了 DRESS 急性和恢复期管理的算法。提供了基于专家共识的 DRESS 综合征管理和治疗逐步指南。
