수두(Varicella) 감염 임산부에서 발생한 아시클로버 유발 신독성

초록

Acyclovir is widely used to treat herpesvirus infections but can cause acute kidney injury (AKI). Acyclovir‑induced AKI typically presents with a rapid rise in serum creatinine (SCr) within 12–48 hours after administration. Early detection is essential to prevent morbidity. We report a case of acyclovir‑induced nephrotoxicity in a pregnant woman with varicella infection during the second trimester. A pregnant woman diagnosed with varicella pneumonia received intravenous acyclovir. Clinical symptoms, laboratory findings, and imaging results were retrospectively reviewed. On day 4 of acyclovir therapy, the patient developed dyspnea, flank pain, and a marked elevation in SCr (0.4→4.4 mg/dL). Acyclovir‑induced crystal nephropathy was suspected, and the drug was discontinued. Aggressive hydration resulted in normalization of renal function within 6 days. The patient later delivered a healthy infant at 37 weeks of gestation. Acyclovir can cause AKI even in pregnant women without underlying renal disease. Close monitoring of renal function is essential during treatment. This is the rare report of acyclovir‑induced nephrotoxicity diagnosed and successfully treated during the second trimester of pregnancy.

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