Bongkrekic acid (BA) poisoning can progress rapidly and lead to the failure of multiple organs, such as brain, liver and kidney. The mortality of BA poisoning is 40–100%. Little information is available on the toxicokinetic parameters of BA in human. Although hemodialysis is widely utilized for patients with severe BA poisoning, the exact amount of BA removed by hemodialysis is poorly documented. We analyzed toxicokinetic parameters, endogenous clearance and hemodialysis clearance in a patient with BA poisoning.

A 27-year-old male developed symptoms of severe diarrhea, nausea, vomiting and weakness after eating rice noodles for more than one day. The patient developed multiple organ failures, especially the liver. Initial serum BA concentration was 0.5μg/mL. He received plasmapheresis, routing, and Oxiris-based Continuous Renal Replacement Therapy (CRRT). The whole blood, serum, urine and dialysate BA concentrations were collected and analyzed hourly. Toxicokinetic parameters relationships were determined using noncompartmental analysis. The clearances were determined using standard pharmacokinetic calculations. The disposition of BA was characterized by a long half-life (t1/2 of 102) and high max plasma (CL of 129,000 L/h/kg) following ingestion of contaminated food. The average serum clearance of BA during PE is remarkable higher than CRRT and the endogenous clearance. In contrast, the rates of decline in blood levels during the CRRT treatments were similar to the natural rate of decline. The total amount of BA removed by Plasmapheresis was 5.51mg. However, most CRRT failed to eliminate BA. We report a rare case of BA poisoning with a complication of liver failure and acute kidney damage. The patient expired, even with supportive care, plasmapheresis and hemodialysis. Analysis of whole blood, serum, urine and dialysate concentrations showed limited efficacy of CRRT in removing BA from blood. In contrast, there was significant extraction of BA from Plasmapheresis.

Bongkrekic Acid (BA) 中毒会迅速进展并导致多个器官衰竭，例如脑、肝和肾。BA中毒的死亡率为40-100%。关于 BA 在人体中的毒代动力学参数的信息很少。尽管血液透析广泛用于治疗严重的 BA 中毒患者，但血液透析去除的 BA 的确切量却鲜有记录。我们分析了一名 BA 中毒患者的毒代动力学参数、内源性清除率和血液透析清除率。

一名27岁男性，食用米粉一天多后，出现严重腹泻、恶心、呕吐、虚弱症状。患者出现多器官衰竭，尤其是肝脏。初始血清BA浓度为0.5μg/mL。他接受了血浆置换、路由和基于 Oxiris 的连续肾脏替代疗法 (CRRT)。每小时收集并分析全血、血清、尿液和透析液 BA 浓度。使用非房室分析确定毒代动力学参数关系。使用标准药代动力学计算确定清除率。BA 处置的特点是摄入受污染的食物后半衰期长（t1/2 为 102）且最大血浆浓度高（CL 为 129,000 L/h/kg）。PE期间BA的平均血清清除率显着高于CRRT和内源性清除率。相比之下，CRRT 治疗期间血液水平下降率与自然下降率相似。通过血浆去除术去除的BA总量为5.51mg。然而，大多数 CRRT 未能消除 BA。我们报告了一例罕见的 BA 中毒病例，并伴有肝功能衰竭和急性肾损伤的并发症。即使接受了支持治疗、血浆置换和血液透析，患者还是去世了。对全血、血清、尿液和透析液浓度的分析表明，CRRT 从血液中去除 BA 的效果有限。相比之下，通过血浆去除术可显着提取 BA。