Life-threatening corrosive injury with hepato-renal-pulmonary failure in boric acid poisoning

• Published in: Postgraduate medical journal Vol. 98; no. 1155; pp. 70 - 71
• Main Authors: Singh, Harpreet, Dhibar, Deba Prasad, Naidu, G S R S N K
• Format: Journal Article
• Language: English
• Published: England The Fellowship of Postgraduate Medicine 01.01.2022; Oxford University Press
• Subjects: Adult intensive & critical care; Boric Acids; Case reports; Caustics; Humans; Insecticides; INTENSIVE & CRITICAL CARE; Pesticides; Poisoning; Preservatives; Suicidal behavior; TOXICOLOGY; INTENSIVE & CRITICAL CARE; TOXICOLOGY; Adult intensive & critical care
• ISSN: 0032-5473; 1469-0756
• DOI: 10.1136/postgradmedj-2020-138470

Boric acid is used for preparing many topical medicine and pesticide or herbicidal agents. 1 Suicidal or accidental ingestion of boric acid with life-threatening complications have been reported previously. 2 Minimum lethal doses of boric acid by oral exposure range from 2–3 g in infants, 5–6 g in children and 15–20 g for adults or at least concentration of 1000 µg/mL in serum. 3 4 Acute boric acid poisoning can present with non-specific symptoms like nausea, vomiting, diarrhoea and abdominal pain. 4 It causes erosions of respiratory and gastrointestinal mucosa due to corrosive nature and may lead on to hypotension, metabolic acidosis, liver injury, oliguric renal failure and rspiratory failure, like in our case. 4 5 Paraquat poisoning may also have similar hepatorenal and pulmonary involvement with poor outcomes. Exact mechanism of boric acid toxicity is not clear; due to formation of complexes among boron and hydroxyl compounds, there is decrease in glucose, glycogen and lactate metabolites. With this article, we would like to increase awareness among farmers and civilians that boric acid is a corrosive agent which can cause hepatic, renal and pulmonary dysfunction and it should not be used as insecticide for preserving any food grains.