Marsaudon E, Castet D, Barrault M F, Allais C
Service de Médecine Interne, Centre Hospitalier de Châteauroux.
Rev Mal Respir. 1997 Nov;14(5):405-7.
Bromocriptine, used in the treatment of acromegaly, hyperprolactinemia and Parkinson's disease, may be responsible in this last case, for pleuro-pulmonary complications in higher doses. Since 1981 about thirty cases were described. It was mostly pleural effusions, pleural thickening and parenchymal lung fibrosis. The prevalence of pleuro-pulmonary diseases is between 2 to 5% after 5 years with bromocriptine that varied in dosage from 20 to 90 mg daily. The patients developed symptoms from nine months to four years. We report a case of a patient treated for one year for Parkinson's disease with daily dose of 105 mg of bromocriptine in whom bilateral pulmonary infiltrate was discovered with a deterioration in the general physical state and dyspnea. There was a favorable clinical and chest roentgenogram outcome following the cessation of treatment, in six months. The hypotheses to explain the pathogenesis of these disorders were always discussed: a vascular theory, an immunological theory or a toxic fibrogenesis induced by the molecule acting on dopaminergic receptors and serotonergic synapses. Now, in our knowledge, these complications justify a clinical and chest roentgenogram follow up for any patients treated with bromocriptine.
溴隐亭用于治疗肢端肥大症、高泌乳素血症和帕金森病，在治疗帕金森病时，高剂量使用可能导致胸膜肺部并发症。自1981年以来，已有约30例相关病例被报道。主要表现为胸腔积液、胸膜增厚和肺实质纤维化。使用溴隐亭治疗5年后，胸膜肺部疾病的患病率在2%至5%之间，每日剂量为20至90毫克。患者出现症状的时间为9个月至4年。我们报告一例帕金森病患者，使用每日剂量105毫克溴隐亭治疗1年，发现双侧肺部浸润，全身状况恶化并出现呼吸困难。停药6个月后，临床症状和胸部X线检查结果均有改善。关于这些疾病发病机制的假说一直在讨论中：血管理论、免疫理论或该分子作用于多巴胺能受体和5-羟色胺能突触诱导的毒性纤维生成。目前，据我们所知，这些并发症表明，任何接受溴隐亭治疗的患者都需要进行临床和胸部X线检查随访。
