Pleuropulmonary disease due to pergolide use for restless legs syndrome

Pergolide is an ergot-derived dopamine agonist used in Parkinson's disease and, increasingly, in restless legs syndrome. We report a patient with a 2. 5-year history of weight loss, pleuropulmonary fibrosis, and exudative pleu ral effusion that developed insidiously while taking this medication. The e xtensive and invasive workup that preceded the diagnosis highlights the dif ficulty in attributing such a process to a drug reaction. This is the secon d report of such a reaction to pergolide, which is one of the increasing nu mber of ergot-derived compounds in common clinical use.