Spanish Guidelines for Diagnosis, Management, Treatment, and Prevention of DRESS Syndrome
Spanish Guidelines for Diagnosis, Management, Treatment, and Prevention of DRESS Syndrome
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DOI：
10.18176/jiaci.0480
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发表时间：
2020-01-01
影响因子：
7.2
通讯作者：
Bellon, T.
中科院分区：
文献类型：
--
作者：
Cabanas, R.;Ramirez, E.;Bellon, T.
背景：药物反应伴嗜酸性粒细胞增多症和全身症状综合征(DRESS)综合征是一种复杂的多系统严重药物超敏反应，诊断和治疗较为麻烦。着装综合症需要各种专家的治疗。正确识别罪魁祸首药物对于确保患者未来的安全治疗选择至关重要。目的：根据现有的科学证据和多学科专家的经验，起草一份关于着装综合征的临床诊断、变态反应检查、管理、治疗和预防的综述和指南。方法：这些指南是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其他参与着装综合征管理的医学专家和PIELenRed财团的研究人员共同起草的。对有关着装综合症的科学论文进行了审查，专家小组对文献证据的质量进行了评估，并提供了推荐等级。每当证据不足时，专家们就会达成共识。结果：西班牙第一份关于着装综合症的指南现已发布。讨论了重要方面，包括关于临床诊断的实用建议、通过西班牙药物警戒系统算法识别罪魁祸首药物以及过敏检查。提供了管理、治疗和预防方面的建议。急性期和恢复期的着装管理算法已经起草完毕。提供了基于专家共识的衣着综合症管理和治疗的循序渐进指南。
Background: 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.Aim: 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.Methods: 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.Results: 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.