Intravenous Immunoglobulin Induced Transaminitis

Intravenous immunoglobulin (IVIG) is a common therapeutic modality used in immune-mediated neuropathy. While the therapeutic benefits are well known, adverse reactions have been reported. One such adverse event, though rare, is transaminitis, which appears to be a transient and a self-limiting adverse reaction. Though most of the cases implicate the stabilizing agent to be the culprit, the exact mechanism is unknown. Thus far, it has been speculated that maltose, which has been commonly used as a stabilizer, is the cause of IVIG transaminitis. We present a unique case of a patient who developed transaminitis post-IVIG in which glycine was used as a stabilizing agent. We aim to draw a potential association between IVIG therapy and the development of transaminitis, thereby providing insight into the underlying mechanisms, as well as clinical features, and possibly encouraging further research on this topic.