[Diffuse interstitial lung disease without pleural involvement and high-dose bromocriptine]

Bromocriptine, used in the treatment of acromegaly, hyperprolactinemia and Parkinson's disease, may be responsible in this last case, for pleuro-pulmonary complications in higher doses. Since 1981 about thirty cases were described. It was mostly pleural effusions, pleural thickening and parenchymal lung fibrosis. The prevalence of pleuro-pulmonary diseases is between 2 to 5% after 5 years with bromocriptine that varied in dosage from 20 to 90 mg daily. The patients developed symptoms from nine months to four years. We report a case of a patient treated for one year for Parkinson's disease with daily dose of 105 mg of bromocriptine in whom bilateral pulmonary infiltrate was discovered with a deterioration in the general physical state and dyspnea. There was a favorable clinical and chest roentgenogram outcome following the cessation of treatment, in six months. The hypotheses to explain the pathogenesis of these disorders were always discussed: a vascular theory, an immunological theory or a toxic fibrogenesis induced by the molecule acting on dopaminergic receptors and serotonergic synapses. Now, in our knowledge, these complications justify a clinical and chest roentgenogram follow up for any patients treated with bromocriptine.