Ticlopidine treatment in idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia accompanied by nephrotic syndrome.

A 36-year-old woman was admitted for idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia (IPL) associated with nephrotic syndrome. She was expected to lapse into renal failure because renal biopsy showed focal glomerulosclerosis. VEMP chemotherapy and bolus methyl prednisolone were not effective against excessive urine protein of over 10 g/day. We thus began administration of ticlopidine (6 mg/kg/day), prednisolone (0.4 mg/kg/day) and cyclophosphamide (1 mg/kg/day). After 3 months of this regimen, the urine protein level decreased to less than 0.5 g/day, and renal function was maintained for more than 3 years. It is suggested that ticlopidine is effective for nephropathy complications associated with IPL.