RT Journal Article
SR Electronic
T1 Pleural disease during treatment with bromocriptine in patients previously exposed to asbestos
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2711
OP 2715
DO 10.1183/09031936.97.10122711
VO 10
IS 12
A1 G Hillerdal
A1 J Lee
A1 A Blomkvist
A1 A Rask-Andersen
A1 M Uddenfeldt
A1 H Koyi
A1 E Rasmussen
YR 1997
UL http://erj.ersjournals.com/content/10/12/2711.abstract
AB Bromocriptine, which is used in the treatment of Parkinson's disease, can cause adverse pleuropulmonary reactions. Exposure to asbestos can result in similar lesions. Fifteen patients with former exposure to asbestos, who developed pleural fibrosis after treatment with bromocriptine, were observed independently in Sweden (11 patients) and Australia (four patients). The patients complained of malaise, often associated with weight loss, dyspnoea, and a disturbing cough. Laboratory values included increased erythrocyte sedimentation rate and a low haemoglobin level. Lung function tests showed a restrictive lung function defect. Chest radiographs showed bilateral pleural fibrosis, with small amounts of fluid in some cases. Soon after bromocriptine was withdrawn, the patients improved clinically, and the laboratory values returned to normal. However, in most cases, pleural fibrosis and a restrictive lung function defect persisted to some extent. In conclusion, in patients who develop pleuropulmonary fibrosis whilst being treated with bromocriptine, former exposure to asbestos should be investigated. Conversely, when pleural changes develop in a patient on bromocriptine and with prior exposure to asbestos, the possible causative role of the drug should be discussed. Special follow-up may be indicated when bromocriptine is planned in a patient with previous asbestos exposure, and if symptoms or signs of pleural fibrosis develop, bromocriptine withdrawal should be considered.