More than ten years experience has confirmed the value of the dopamine agonist bromocriptine in the treatment of Parkinsons disease. Good results have been reported in patients with end-of-dose deterioration and levodopa-induced dyskinesias, and recent studies suggest a beneficial effect from early treatment with a combination of levodopa and bromocriptine. The side effects of short-term and medium-term use of bromocriptine are fairly well recognized. Although the association of pleuropulmonary disorders with long-term use of the drug has not been convincingly proved, accumulating evidence suggests a cause-and-effect relationship. Since the first report by Rinne, in which he described seven patients with pleuropulmonary changes among 123 Finnish parkinsonian patients, nearly 20 cases have been reported, most of them in European patients. In 1985, we started a search for this presumed association among patients admitted to hospital with pleuropulmonary disorders. The findings of the first four patients discovered during a one-year period are reported. http://www.medicine-against-diabetes.net/
The patient characteristics and roentgenographic appearances are presented in Table 1. All were men. Patients 1 and 3 were nonsmokers, patient 2 was an exsmoker for 13 years, and patient 4 smoked a few cigarettes a day No one had occupational exposure to asbestos. The patients had received regular obligatory chest roentgenograms according to the Finnish practice (between 55 and 69 years of age every fourth year and after the age of 70 every second year). Those of patients 1 and 4 had previously been normal. In patient 2, the chest-x-ray film three years before admission showed some bilateral pleural thickening In patient 3, the chest x-ray film showed mild basal interstitial changes and bilateral pleural thickening at the time that bromocriptine treatment was started four years earlier. The symptoms leading to referral were dyspnea (patients 1, 2, and 3), cough (patient 3), and fatigue (patients 1 and 4).
Table 1—Details of Patients and Roentgenographic Findings at Presentation
|Patient||Age,yr||Duration of Bromocriptine Treatment, mo||Maximal Daily Dose, mg||Chest X-ray Film Findings*|