Intravenous Glutathione and Vitamin Supplementation Causing Stevens-Johnson Syndrome: A Case Report

Stevens-Johnson syndrome and toxic epidermal necrolysis are severe mucocutaneous reactions with high morbidity and mortality, most commonly triggered by prescribed medications. Here we report a case of a 33-year-old female who developed Stevens-Johnson/toxic epidermal necrolysis after receiving an IV vitamin infusion containing glutathione, vitamin C, and vitamin D. While not commonly associated with the development of Stevens-Johnson syndrome, glutathione has been previously reported to have been the inciting agent in Stevens-Johnson syndrome cases. Concerns over glutathione's association with Stevens-Johnson syndrome have led the FDA in the Republic of the Philippines to issue a warning over the potential associations between glutathione and Stevens-Johnson syndrome. With the rise in relatively unregulated IV hydration clinics in the United States, where IV vitamin infusions are frequently completed, our case highlights the potential severe risks. In addition, our case highlights the need for providers to complete a thorough review of a patient's history, including inquiring about hydration and wellness center infusions, when trying to determine potential inciting factors in Stevens-Johnson syndrome and toxic epidermal necrolysis.