PLEUROPULMONARY CHANGES DURING BROMOCRIPT INE TREATMENT

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 Cup to 35 mg daily) was added to the medication 9 years ago. 3 1/2 years ago he developed exertional dy spnoea 9 (NYHA class II-III) and lost 5 kg in weight. Chest radiograph y demonstrated pleural effusion and interstitial pulmonary changes in both lung bases. Erythrocyte sedimentation rate was 37 mm in the first hour a and the white cell count 10,400/mu l. Extensive tests failed t o find malignant tumour or any infectious-inflammatory condition. As i t was suspected that the pleuropulmonary changes were associated with the bromocriptine intake, it was discontinued and biperiden and selegi line substituted for it. The pleural effusion regressed almost complet ely within 8 weeks, and the laboratory tests pointing to inflammation disappeared completely. Clinical, biochemical and radiological tests h ave remained normal for the last 3 years. The clinical course makes a causal relationship between bromocriptine intake and the pleuropulmona ry changes highly probable.