A Case Report on the Long-term Management and Clinical Efficacy of <i>Ikwiseungyang-tang</i> Gami for a Pediatric Patient with Chronic, Recurrent Immune Thrombocytopenic Purpura

Objectives: This study describes the clinical course of a pediatric patient with persistent and recurrent immune thrombocytopenia (ITP) who received Korean medicine treatment.Methods: A 6-year-old boy with a 3-year history of recurrent ITP and epistaxis received <i>Ikwiseungyang-tang</i> Gami treatment over a 3-year, 3-month follow-up period. A total of 7 prescriptions were used. Platelet count was the primary outcome, whereas epistaxis frequency, digestion, and sleep quality were secondary outcomes.Results: During the follow-up period, platelet counts fluctuated according to intercurrent infections and other clinical conditions. The platelet count increased during several periods, and epistaxis and digestive symptoms also improved. According to the guardian's report, the platelet count decreased to 30,000/μL during an influenza infection and then increased to 160,000/μL within 5 days without IVIG treatment in February 2026.Conclusion: <i>Ikwiseungyang-tang</i> Gami was administered over a long-term follow-up period in a pediatric patient with recurrent ITP, and changes in platelet counts and clinical symptoms were observed. However, it is difficult to determine whether the herbal medicine directly contributed to these changes because spontaneous fluctuations and remission during the natural course of pediatric ITP cannot be excluded. This case suggests that Korean medicine may have a role as a complementary treatment option for the long-term management of pediatric ITP.