Constrictive pericarditis and pleuropulmonary disease linked to ergot dopamine agonist therapy (cabergoline) for Parkinson's disease

Mayo Clin Proc. 1999 Apr;74(4):371-5. doi: 10.4065/74.4.371.

Abstract

Cabergoline is one of several ergoline dopamine agonist medications used in the treatment of Parkinson's disease (PD). We diagnosed constrictive pericarditis (CP) in a patient with PD receiving cabergoline therapy (10 mg daily), who had symptoms and signs of congestive heart failure (CHF). In the absence of previous reported cases of this condition linked to ergoline drugs, cabergoline was not initially identified as the cause. Shortly thereafter, however, the patient developed of a severe pleuropulmonary inflammatory-fibrotic syndrome, a recognized complication of ergoline medications, thus suggesting a common pathogenesis due to cabergoline therapy. To our knowledge, this is the first case in the English literature, although we speculate that CP may be more common than reported among patients with PD who are treated with an ergoline drug (cabergoline, bromocriptine, pergolide, or lisuride). The diagnosis of CP is difficult and requires a high level of suspicion; symptoms may masquerade as CHF due to common mechanisms such as coronary artery disease. In patients with PD who are taking not only cabergoline but also one of the other ergoline drugs, CP should be suspected if symptoms of CHF develop.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antiparkinson Agents / adverse effects*
  • Antiparkinson Agents / therapeutic use
  • Cabergoline
  • Dopamine Agonists / adverse effects*
  • Dopamine Agonists / therapeutic use
  • Ergolines / adverse effects*
  • Ergolines / therapeutic use
  • Humans
  • Lung Diseases / chemically induced*
  • Lung Diseases / diagnostic imaging
  • Male
  • Parkinson Disease, Secondary / drug therapy*
  • Pericarditis, Constrictive / chemically induced*
  • Pericarditis, Constrictive / diagnostic imaging
  • Pleural Diseases / chemically induced*
  • Pleural Diseases / diagnostic imaging
  • Tomography, X-Ray Computed

Substances

  • Antiparkinson Agents
  • Dopamine Agonists
  • Ergolines
  • Cabergoline