A case report of massive acute boric acid poisoning

Boric acid comes as colourless, odourless white powder and, if ingested, has potential fatal effects including metabolic acidosis, acute renal failure and shock. An 82-year-old male was brought to the emergency room 3 h after unintentional ingestion of a large amount of boric acid. Clinical course was monitored by collecting data at admittance, 12 h after admission, every 24h for 5 days and again 1 week after admission. During the first 132h, serum and urinary concentrations of boric acid were measured. Serum boric acid levels decreased from 1800 to 530μg/ml after haemodialysis and from 530 to 30μg/ml during the forced diuresis period. During dialysis, boric acid clearance averaged 235ml/min with an extraction ratio of 70%. The overall patient's condition steadily improved over 84h after admission. In conclusion, early treatment with forced diuresis and haemodialysis may be considered for boric acid poisoning, even if signs of renal dysfunction are not apparent, to prevent severe renal damage and its complications. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.