Background: Treating children with chronic, refractory immune thrombocytopenia (ITP) remains a challenging issue. Conventional treatments, such as glucocorticoids and intravenous immunoglobulin (IVIG), are commonly used; however, some patients exhibit a poor response to these interventions. Throughout the history of traditional Chinese medicine (TCM), numerous texts have documented the use of herbal decoctions to treat hematologic diseases; thereby offering an alternative management strategy for children with chronic ITP.

Methods: This report describes a 6-year-and-1-month-old girl with chronic ITP who showed limited response to glucocorticoids and IVIG. Following complementary therapy with a traditional Chinese medicine formula, she achieved a sustained platelet response that was maintained within a safe range, averaging 50,000/μL, over the subsequent three years, with no signs of bleeding.

Conclusions: The pathophysiology of ITP is linked to antiplatelet antibodies and a lack of immune suppression. Scientific studies have shown that TCM formulations, such as Guipi Decoction, Ziyin Jianghou Decoction, and Shengxuexiaoban Capsules, possess immunoregulatory effects that help restore platelet production while exerting anti-inflammatory and hematopoietic properties. For pediatric patients with chronic or refractory ITP, integrative approaches, including TCM, may offer additional therapeutic benefits by enhancing platelet counts.