Schmid P A, Suter T, Speich R, Eberli F, Greminger P
Departement für Innere Medizin, Universität Zürich.
Dtsch Med Wochenschr. 1994 Nov 11;119(45):1543-6. doi: 10.1055/s-2008-1058870.
A 64-year-old man was diagnosed to have Parkinson's disease when aged 42 years and since then has been treated with levodopa and benserazide (up to 875 mg daily). Bromocriptine (up to 35 mg daily) was added to the medication 9 years ago. 3 1/2 years ago he developed exertional dyspnoea (NYHA class II-III) and lost 5 kg in weight. Chest radiography demonstrated pleural effusion and interstitial pulmonary changes in both lung bases. Erythrocyte sedimentation rate was 37 mm in the first hour and the white cell count 10,400/microliters. Extensive tests failed to find malignant tumour or any infectious-inflammatory condition. As it was suspected that the pleuropulmonary changes were associated with the bromocriptine intake, it was discontinued and biperiden and selegiline substituted for it. The pleural effusion regressed almost completely within 8 weeks, and the laboratory tests pointing to inflammation disappeared completely. Clinical, biochemical and radiological tests have remained normal for the last 3 years. The clinical course makes a causal relationship between bromocriptine intake and the pleuropulmonary changes highly probable.
一名64岁男性在42岁时被诊断患有帕金森病，从那时起一直接受左旋多巴和苄丝肼治疗（每日剂量高达875毫克）。9年前开始在药物治疗中添加溴隐亭（每日剂量高达35毫克）。3年半前，他出现劳力性呼吸困难（纽约心脏协会II - III级），体重减轻了5千克。胸部X线检查显示双侧肺底部有胸腔积液和间质性肺改变。红细胞沉降率在第1小时为37毫米，白细胞计数为10400/微升。广泛检查未发现恶性肿瘤或任何感染性炎症疾病。由于怀疑胸膜肺部改变与服用溴隐亭有关，遂停用溴隐亭，改用安坦和司来吉兰替代。胸腔积液在8周内几乎完全消退，提示炎症的实验室检查结果完全消失。在过去3年中，临床、生化和放射学检查一直正常。该临床病程极有可能表明服用溴隐亭与胸膜肺部改变之间存在因果关系。
