Ciubotaru V, Poinsignon Y, Brunet-Bourgin F, Mestassi M, Rosenbaum D
Service de médecine interne, centre hospitalier Bretagne-Atlantique, BP 70555, 56017 Vannes cedex, France.
Rev Med Interne. 2004 Apr;25(4):310-4. doi: 10.1016/j.revmed.2004.01.004.
Bromocriptin, member of the class of ergolines, is commonly prescribed as treatment of Parkinson's disease. Apart from vascular, digestif, neurologic and psychic disorders, the authors report cases of retroperitoneal fibrosis and pleural effusion, as adverse reactions related to the bromocriptin.
About 40 cases of skin, pleural, lung and retroperitoneal attacks were described after long term and high doses of bromocriptin. More ten years ago, the first case of constrictive pericarditis was cited in the medical literature, and the bromocriptin was incriminated as responsible. Since then, two other cases were cited. Our observation is a constrictive pericarditis, found in a 72 years old patient treated with bromocriptin for Parkinson's disease since five years (cumulative dose intake 73 grams). Investigations aimed to establish etiology were negative. Bromocriptin is suspected and the treatment is discontinued. As in the three other cases, cardiac and neurologic conditions markedly improved after bromocriptin's withdrawal. A pericardic thickening persists at the echography.
The responsibility of bromocriptin in the etiology of constrictive pericarditis is seldom discussed, because it remains an exclusion diagnosis. Periodic chest X-ray and echocardiography should be considered in patients with long-term bromocriptin treatment.
麦角隐亭是麦角碱类药物的一种，常用于治疗帕金森病。除血管、消化、神经和精神疾病外，作者报告了腹膜后纤维化和胸腔积液病例，这些都是与麦角隐亭相关的不良反应。
长期大剂量使用麦角隐亭后，有40例皮肤、胸膜、肺部和腹膜后不良反应的病例被报道。十多年前，医学文献中首次引用了缩窄性心包炎病例，并将麦角隐亭认定为病因。此后，又引用了另外两例病例。我们观察的是一名72岁的患者，他因帕金森病服用麦角隐亭五年（累积剂量73克）后出现缩窄性心包炎。旨在确定病因的检查结果为阴性。怀疑是麦角隐亭导致的，于是停止了治疗。与其他三例病例一样，停用麦角隐亭后，心脏和神经状况明显改善。超声心动图显示心包增厚仍然存在。
麦角隐亭在缩窄性心包炎病因中的作用很少被讨论，因为它仍然是一种排除性诊断。长期接受麦角隐亭治疗的患者应定期进行胸部X光检查和超声心动图检查。
