Pergolide-induced dyspnea, bilateral pleural effusion and peripheral edema

Area of Science:

• Neurology
• Cardiology
• Pharmacology

Background:

• Parkinson's disease (PD) management often involves dopamine agonists.
• Fluid retention can be a complex symptom with multifactorial causes.

Observation:

• A patient with severe Parkinson's disease experienced progressive dyspnea, bilateral pleural effusion, and peripheral edema.
• These symptoms were refractory to standard diuretic therapy and initially misdiagnosed as right-sided heart failure.

Findings:

• Pergolide, a dopamine agonist, was identified as the sole cause of the patient's severe fluid retention.
• Discontinuation of pergolide led to the complete resolution of all signs of fluid overload.

Implications:

• This case underscores the importance of considering drug-induced fluid retention in Parkinson's disease patients presenting with unexplained edema and effusions.
• Dopamine agonists, particularly ergots like pergolide, can precipitate serious adverse reactions mimicking cardiac dysfunction.
• Awareness of these potential drug reactions is crucial for accurate diagnosis and effective management in clinical practice.