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Dopamine Agonist – Peripheral Oedema — SCE Neurology MCQ

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HardMovement DisordersDopamine Agonist – Peripheral OedemaSCE Neurology

A patient with Parkinson disease develops bilateral ankle oedema after ropinirole is increased. Echocardiography, renal and hepatic tests are normal and venous ultrasonography excludes thrombosis. What is the most likely explanation?

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Correct answer: DDose-related peripheral oedema caused by ropinirole treatment

The best answer is “Dose-related peripheral oedema caused by ropinirole treatment”. Peripheral oedema is a recognised dopamine-agonist adverse effect; the temporal dose relationship and exclusion of cardiac, renal, hepatic and thrombotic causes support ropinirole as the culprit. “Occult bilateral deep-vein thrombosis causing dependent oedema” is less appropriate because DVT is usually asymmetric and has been excluded by appropriate imaging “Nephrotic syndrome causing symmetric dependent oedema” is less appropriate because nephrotic oedema requires proteinuria and hypoalbuminaemia “Lower-limb cellulitis causing bilateral inflammatory swelling” is less appropriate because cellulitis produces inflammatory skin findings “Levodopa withdrawal syndrome causing autonomic oedema” is less appropriate because the patient has not withdrawn levodopa and that syndrome does not present as isolated ankle oedema

Reference: Ropinirole tablets: SmPC. https://www.medicines.org.uk/emc/product/9905/smpc