McElvaney N G, Wilcox P G, Churg A, Fleetham J A
Department of Medicine, University Hospital, Vancouver, British Columbia, Canada.
Arch Intern Med. 1988 Oct;148(10):2231-6.
Pleuropulmonary disease has been observed in eight patients with Parkinson's disease treated with bromocriptine or its related compound, mesulergine. The pleuropulmonary changes included pleural effusions, pleural thickening, and parenchymal lung disease. The patients developed symptoms from nine months to four years after starting treatment with bromocriptine that varied in dosage from 22 to 50 mg daily, while the patient receiving mesulergine was taking 6 mg daily. No other cause was found for the pleuropulmonary changes. In six patients the medication was discontinued with subsequent clinical, physiologic, and radiologic improvement. In two patients bromocriptine treatment was continued for one to two years, and in one patient there was further physiologic and radiologic progression of the pleuropulmonary changes. These findings suggest a causal relationship between bromocriptine treatment and pleuropulmonary disease. We recommend a chest roentgenogram and pulmonary function evaluation prior to bromocriptine treatment with follow-up studies if the patient develops respiratory symptoms. Physicians prescribing bromocriptine should be aware of this side effect to ensure early recognition and prompt withdrawal of bromocriptine therapy.
在8例接受溴隐亭或其相关化合物美舒麦角治疗的帕金森病患者中观察到胸膜肺部疾病。胸膜肺部改变包括胸腔积液、胸膜增厚和实质性肺部疾病。这些患者在开始使用溴隐亭治疗9个月至4年后出现症状，溴隐亭的日剂量为22至50毫克，而接受美舒麦角治疗的患者日剂量为6毫克。未发现胸膜肺部改变的其他原因。6例患者停药后临床、生理和影像学表现均有改善。2例患者继续使用溴隐亭治疗1至2年，1例患者胸膜肺部改变在生理和影像学上进一步进展。这些发现提示溴隐亭治疗与胸膜肺部疾病之间存在因果关系。我们建议在使用溴隐亭治疗前进行胸部X线检查和肺功能评估，若患者出现呼吸道症状则进行随访研究。开具溴隐亭处方的医生应知晓这一副作用，以确保早期识别并及时停用溴隐亭治疗。
