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Review
. 2025;85(3):572-585.

[DRESS syndrome due to antituberculosis drugs. Review and comments]

[Article in Spanish]
Laura Lagrutta  1   2 , Ana Gamberale  1 , Bruno Bartoletti  1 , Adriana Rodríguez Mieres  1 , Rodrigo Failde  1   3 , Fernanda Bornengo  3 , Sandra Inwentarz  3 , Marisa Vescovo  1   3 , Graciela Casado  1 , Domingo Palmero  1   3
Affiliations
  • PMID: 40577144
Free article
Review

[DRESS syndrome due to antituberculosis drugs. Review and comments]

[Article in Spanish]
Laura Lagrutta et al. Medicina (B Aires). 2025.
Free article

Abstract
in English, Spanish

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.

El síndrome DiHS/DRESS (síndrome de hipersensibilidad inducido por fármacos/reacción a fármacos con eosinofilia y síntomas sistémicos) por fármacos antituberculosis es una reacción adversa poco frecuente, pero grave, que afecta tanto a adultos como a niños, pudiendo comprometer el éxito del tratamiento y en última instancia, la vida del paciente. El fármaco más frecuentemente relacionado fue la rifampicina. Es crucial identificar el/los agentes causales precozmente, dado que las manifestaciones pueden progresar rápidamente y llevar a complicaciones potencialmente mortales, como el fallo multiorgánico. El DiHS/DRESS es provocado por una reacción de hipersensibilidad a fármacos, que se manifiesta por fiebre, adenopatías, erupción, eosinofilia y afectación visceral. Este síndrome heterogéneo con compromiso sistémico y potencialmente fatal debe ser abordado por un equipo multidisciplinario. No existe un protocolo único de manejo del DiHS/DRESS y en esta revisión narrativa analizamos la bibliografía internacional a la luz de la experiencia acumulada en su manejo en un centro de referencia para tuberculosis.

Keywords: DRESS syndrome; DiHS/DRESS; adverse reactions; antituberculosis drugs; eosinophilia; hypersensitivity.

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