Supplementary Material for: Intravenous immunoglobulin therapy induced Erythema multiforme in a patient with CLL

This case report discusses immunoglobulin-induced Erythema multiforme, a rare and understudied condition that requires further investigation. The report presents the case of a 69-year-old woman with a history of chronic lymphocytic leukemia, who developed an acute hypersensitivity reaction to the intravenous gamma globulin medication. The patient received IVIG to normalize and stabilize her immunoglobulin levels and reduce the risk of recurrent infections due to her immunodeficiency with predominantly antibody defects. However, after the second administration of the medication, the patient experienced an acute skin rash and was admitted to the hospital for treatment. The treatment plan included systemic desensitizing therapy, systemic antihistamine therapy, corticosteroid therapy, and local therapy. After a course of therapy, the patient's skin condition improved, and her overall well-being improved. However, due to the acute hypersensitivity reaction, the intravenous immunoglobulin (IVIG) therapy was discontinued. The multidisciplinary team of specialists concluded that the patient developed erythema multiforme. The discussion provides an overview of erythema multiforme (EM), including its causes, clinical presentation, diagnostic tools, and therapy principles. The discussion also describes the use of human IVIG preparations in treating various immunodeficient and inflammatory diseases, highlighting the importance of monitoring patients for adverse effects. The case of this patient underscores the potential risks associated with immunoglobulin therapy and emphasizes the need for healthcare providers to remain vigilant for adverse reactions. By promptly diagnosing and treating EM, healthcare providers can minimize its impact on patients' overall well-being.