Boric acid overdose treated using hemodialysis: a case report

Introduction Boric acid poisoning can present with gastrointestinal symptoms and characteristic “boiled lobster” rash. It may lead to renal and hepatic failure and can be fatal. Hemodialysis is recommended in severe cases. However, evidence of its efficacy in eliminating boric acid remains limited.Case A 56-year-old male was brought to the emergency department after ingesting 91 g of boric acid, which likely exceeds the estimated lethal dose, along with surfactant-based toilet cleaner, and a pyrethroid-containing insecticide during a suicide attempt. Gastric lavage was performed since computed tomography revealed residual boric acid in the stomach. He underwent two consecutive rounds of hemodialysis. The plasma boron concentrations were measured, noting half-lives of 2.46 and 3.51 h during hemodialysis and 48.3 h without hemodialysis. He was discharged without sequelae after six days of hospitalization.Discussion Accelerated elimination of boric acid during hemodialysis was evident in the present case. When managing cases of boric acid poisoning exceeding a lethal dose, hemodialysis should be considered.