# Systemic Inflammatory Response Syndrome Following High-Dose Intravenous Glutathione-Containing Revitalising Solution in a Patient on Tirzepatide: A Case Report

## TL;DR

A woman developed severe inflammation after receiving an unregulated glutathione infusion for skin lightening while on a weight-loss drug, highlighting the risks of such treatments.

## Contribution

Reports a rare case of systemic inflammatory response syndrome linked to an unregulated glutathione infusion in a nutritionally compromised patient.

## Key findings

- Patient developed shock, high fever, and coagulopathy after receiving Glutax 75GX DCRP.
- No infectious source was identified, but lab results showed severe inflammation and liver injury.
- Recovery occurred with supportive care, suggesting the reaction was due to the infusion or nutritional status.

## Abstract

Intravenous glutathione-based products are increasingly used for cosmetic purposes despite lacking regulatory approval in the United Kingdom and robust safety data. We report a case of systemic inflammatory response syndrome (SIRS) following administration of Glutax 75GX DCRP, a high-dose unregulated glutathione infusion, in a patient on tirzepatide with prolonged low nutritional intake. A previously healthy woman presented with shock, hyperpyrexia (>41°C), and collapsed within an hour of receiving the infusion for skin lightening. She had been self-administering tirzepatide for weight loss, leading to significant dietary restriction. Laboratory findings included marked leucocytosis (white cell count (WCC), 26 × 10⁹/L), elevated inflammatory markers (C-reactive protein (CRP), 160 mg/L, procalcitonin 28.8 µg/L), acute liver injury (alanine transaminase (ALT), 311 IU/L), and coagulopathy (prothrombin time (PT), 26.4 s), with no infectious source identified. The patient recovered fully with supportive care. We hypothesise that SIRS resulted from either endotoxin contamination of the unregulated product or a synergistic effect of supraphysiological glutathione in a nutritionally compromised host, as supported by literature documenting similar reactions to unregulated infusions. This case highlights the dangers of cosmetic intravenous therapies administered in non-clinical settings and underscores the need for thorough medication and supplement histories in acute presentations. Clinicians should maintain heightened suspicion for such products in unexplained systemic inflammation and advocate for stricter regulatory oversight to mitigate risks.