Alternative therapy for persistent childhood immune thrombocytopenic purpura unresponsive to intravenous immunoglobulin

Objective: Presentation of a case illustrating the benefits of traditional Chinese herbal granules for treatment of immune thrombocytopenic purpura in children. Clinical features: A 4-year-old girl presented with persistent immune thrombocytopenic purpura refractory to the first-line conventional treatment of steroids and intravenous irnmunoglobulin over 7 months. She was brought to the traditional Chinese medical clinic at the Chang Gung Memorial Hospital in 2011 for alternative therapy. She received a modified Chinese herbal formula, Zi-Ying-Jiang-Huo-Tang (Phellodendri Combination), for 6 months and was followed clinically by both a pediatrician and a traditional Chinese medical doctor. The patient had a dramatic improvement in platelet count and entered complete remission after treatment with the traditional Chinese medicine. There was no recurrence of disease or side effects of treatment noted during the 12-month follow-up period. Conclusions: Our case report suggests that collaborative monitoring of treatments with traditional Chinese medicine may prove beneficial in the management of childhood persistent immune thrombocytopenic purpura. A larger clinical study is warranted for further evaluation of the role of Zi-Ying-Jiang-Huo-Tang in treating immune thrombocytopenic purpura. (C) 2013 Elsevier Ltd. All rights reserved.