Chronic constrictive pericarditis induced by long-term bromocriptine therapy: Report of two cases

OBJECTIVE: To report two cases of chronic constrictive pericarditis that ap pear to be related to the intake of bromocriptine for Parkinson's disease. CASE SUMMARY: TWO white men (aged 63 and 69 y) were treated with bromocript ine for four (40 mg/d) and two years (30 mg/d), respectively, with a cumula tive dose intake of 58.4 and 21.9 g, respectively. The patients experienced dyspnea with bilateral lower-limb edema and pleural effusion, suggesting r ight cardiac dysfunction. Echocardiography, computed tomography, and cardia c catheterization results were compatible with a diagnosis of constrictive pericarditis, so pericardectomy was performed on both patients. The anatomi c pathology examination showed a fibrous pericardium; cultures were sterile . In the first case, pleural effusion recurred seven months after the peric arditis; bromocriptine was suspected and treatment was discontinued. In the second case, just prior to the pericardectomy, an episode of mental confus ion occurred and prompted the cessation of bromocriptine therapy. DISCUSSION: To the best of our knowledge, only one case of constrictive per icarditis induced by bromocriptine therapy has previously been described in the literature. CONCLUSIONS: Our eases call attention to a possible association between bro mocriptine use in patients who have Parkinson's disease and constrictive pe ricarditis.