Refractory generalized edema: an infrequent complication of long-term pergolide treatment for Parkinson disease.
Generalized edema is the result of increased interstitial fluid volume due to altered Starling forces or capillary endothelial damage. The authors present a patient with severe Parkinson disease who presented with increasing dyspnea, bilateral pleural effusion, and peripheral edema that was refractory to diuretics. Common causes of the severe loss of fluid into the extravascular space were ruled out and pergolide was suspected. Upon discontinuation of pergolide therapy, all signs of fluid retention resolved. This report emphasizes that pergolide should be considered a cause of otherwise unexplained generalized edema in patients with Parkinson disease on this therapy.
Bianchi
Massimiliano
M
Department of Internal Medicine, Pisa; and Cisanello Hospital, Azienda Ospedaliera Universitaria, Pisana, Italy. massimilianobianchi3@tin.it
Castiglioni
Maido Giovacchino
MG
D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001826:Body Fluids / Q000502:physiology; D004232:Diuretics / Q000627:therapeutic use; D004351:Drug Resistance; D004487:Edema / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D006801:Humans; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy; D010479:Pergolide / Q000009:adverse effects* / Q000627:therapeutic use; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000209:etiology; D014057:Tomography, X-Ray Computed
D000978:Antiparkinson Agents; D004232:Diuretics; D010479:Pergolide; D005665:Furosemide