[Severe pleuropericarditis induced by long-term bromocriptin therapy, report of a case and review of the literature].
BACKGROUND
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.


RESULTS
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.


CONCLUSIONS
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.
Ciubotaru
V
V
Service de médecine interne, centre hospitalier Bretagne-Atlantique, BP 70555, 56017 Vannes cedex, France. vasilica.ciubotaru@ch-bretagne-atlantique.fr
Poinsignon
Y
Y
Brunet-Bourgin
F
F
Mestassi
M
M
Rosenbaum
D
D
D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001971:Bromocriptine / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced*; D008297:Male; D010493:Pericarditis / Q000139:chemically induced*; D010996:Pleural Effusion / Q000139:chemically induced; D012185:Retroperitoneal Fibrosis / Q000139:chemically induced
D000978:Antiparkinson Agents; D001971:Bromocriptine