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.