Lagrutta Laura, Gamberale Ana, Bartoletti Bruno, Rodríguez Mieres Adriana, Failde Rodrigo, Bornengo Fernanda, Inwentarz Sandra, Vescovo Marisa, Casado Graciela, Palmero Domingo
Hospital de Infecciosas Dr. Francisco J. Muñiz, Buenos Aires, Argentina.
Instituto de Tisioneumonología Prof. Dr. Raúl Vaccarezza, Buenos Aires, Argentina. E-mail:
Medicina (B Aires). 2025;85(3):572-585.
DiHS/DRESS (drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms) syndrome due to antituberculosis drugs is a rare but serious adverse reaction that affects both adults and children and can compromise the success of treatment and ultimately the patient's life. The most frequently associated drug was rifampicin. It is crucial to identify the causative agent(s) early, since the manifestations can progress rapidly and lead to potentially fatal complications, such as multiorgan failure. DiHS/ DRESS is caused by a hypersensitivity reaction to drugs, manifested by fever, adenopathy, rash, eosinophilia and visceral involvement. This heterogeneous syndrome with systemic and potentially fatal involvement must be addressed by a multidisciplinary team. There is no unique protocol for the management of DiHS/DRESS, and in this narrative review we analyze the international literature in light of the accumulated experience in its management in a reference centre for tuberculosis.
抗结核药物引起的药物超敏反应综合征/伴嗜酸性粒细胞增多和全身症状的药物反应(DiHS/DRESS)是一种罕见但严重的不良反应,可影响成人和儿童,会影响治疗的成功并最终危及患者生命。最常相关的药物是利福平。尽早识别致病药物至关重要,因为症状可能迅速进展并导致潜在的致命并发症,如多器官功能衰竭。DiHS/DRESS由对药物的超敏反应引起,表现为发热、淋巴结病、皮疹、嗜酸性粒细胞增多和内脏受累。这种具有全身和潜在致命性累及的异质性综合征必须由多学科团队处理。目前尚无针对DiHS/DRESS管理的独特方案,在本叙述性综述中,我们根据一家结核病参考中心在其管理方面积累的经验分析国际文献。