Endocrine Abstracts

Introduction: Dopamine agonists such as cabergoline and bromocriptine are used in the treatment of hyperprolactinemia to provide normoprolactinemia, to improve gonodal functions and to decrease the size of tumour if there is. Besides common side effects, fibrosis is another rare side effect of dopamine agonists. Long-term use of these drugs has been reported to cause fibrotic changes in heart valves. In addition, there are a few case reports about dopamine agonist-related pleural and pulmonary fibrosis.

Patients and methods: In this study, we investigated whether cabergoline and bromocriptine cause fibrosis in heart valves and lungs. The study included 50 (47 females and 3 males) patients treated with cabergoline and/or bromocriptine for hyperprolactinemia and 30 (26 females and 4 males) healthy subjects. In all subjects, transthoracic echocardiography, pulmonary function tests and high resolution computed tomography of the chest were performed.

Results: In the patient group, the mean cabergoline dose was 139±104.53 mg while the mean bromocriptine dose was 3877.77±3418.04 mg. The mean treatment duration was 35.26±23.24 months. Compared to controls, mild tricuspid regurgitation and mitral regurgitation were significantly more frequent in patients taking cabergoline and bromocriptine. Pulmonary fibrosis developed in nine (18%) patients, but statistically there was no difference between the two groups.

Conclusion: Transthoracic echocardiography may be useful for early detection of cardiac valvular fibrosis in patients treated with dopamine agonists. Also, pulmonary fibrosis should be kept in mind and symptomatic patients should be evaluated using radiological methods.