PLEUROPULMONARY CHANGES INDUCED BY ERGOLINE DRUGS

Classic ergolines, such as bromocriptine, methysergide and ergotamine, can induce chronic pleuropneumonitis, We present the cases of eight p atients who developed similar changes whilst on other ergolines. In th is retrospective case study spanning 1985-1995, clinical data, radiolo gical material, pulmonary function, bronchoalveolar lavage and histopa thology were reviewed, Earlier literature on ergoline-induced pleuropu lmonary changes was reviewed. Eight middle-aged to elderly individuals of both sexes developed pleuropulmonary changes during long-term ther apy with regular dosages of nicergoline (n=4), dihydroergocristine (n= 3), or dihydroergotamine (n=1). Bibasilar pleural thickening with or w ithout pleural effusion was present on chest radiographs and computed tomographic (CT) scans in six cases, Increased erythrocyte sedimentati on rate was seen in most. Pure interstitial pneumonitis developed in t wo patients on dihydroergocristine and was reversible in each, Broncho alveolar lavage was performed in four cases and was abnormal in all, b ut demonstrated no consistent pattern, Most patients exhibited lung re striction, The outcome was favourable showing slow improvement in all cases following discontinuation of the ergoline, Slight residual pleur al thickening was seen in five out of the six cases with pleural invol vement. Nicergoline and dihydroergotamine can induce a syndrome of chr onic pleural thickening/effusion that slowly improves after drug withd rawal, Dihydroergocristine can induce reversible interstitial pneumoni tis.