Successful treatment of idiopathic thrombocytopenic purpura by Chinese herbal medicine EK‐49 and ascorbic acid in an elderly patient developing chronic subdural hematoma

Abstract

Treatment of idiopathic thrombocytopenic purpura can present difficult therapeutic choices. An 88‐year‐old woman was admitted for treatment of a right subdural hematoma. She had a history of chronic thrombocytopenia, with follow‐up evaluations by a local physician. Platelet count on admission was 5 × 103/µL, with a high serum concentration of platelet‐associated immunoglobulin G. Bone marrow examination showed a marked increase in megakaryocytes. The patient was diagnosed with idiopathic thrombocytopenic purpura accompanied by chronic subdural hematoma. An increase in platelet count and gradual resolution of the subdural hematoma were obtained with prednisolone and azathioprine administration, but platelet count decreased when steroid tapering was attempted. Ultimately we administered the Chinese herbal medicine EK‐49 and ascorbic acid, with a gradual increase in platelet count and no adverse effects. Some elderly patients with chronic subdural hematoma can be treated non‐invasively. Further, a combination of EK‐49 and ascorbic acid may be an effective treatment for refractory idiopathic thrombocytopenic purpura.

Platelets in the perspective of COVID-19; pathophysiology of thrombocytopenia and its implication as prognostic and therapeutic opportunity

“…Shen-Cao granule is another traditional Chinese medicine with the ability to increase the number of PLTs [150] . Hirano et al also evaluated the efficacy of EK-49 and ascorbic acid in idiopathic ITP patients and suggested that while these agents could overcome thrombocytopenia, the conventional treatments such as prednisolone and azathioprine failed to recover low platelets [151] . Taken together, it seems that traditional Chinese medicine could be positioned as a pillar of thrombocytopenia treatment; however, it should not be forgotten that the safety and the tolerability of these agents have not been tested in COVID-19 patients yet.…”

Effect of kamikihito on platelet count: Retrospective pilot study

“…reported that KKT increased the platelet count by 31.7% and was clinically effective in 40.9% of 168 chronic idiopathic thrombocytopenic purpura patients . Hirano and Ueoka reported the case of an 88‐year‐old woman whose chronic subdural hematoma was successfully treated with KKT and ascorbic acid, which improved thrombocytopenia caused by idiopathic thrombocytopenic purpura . Yanase et al .…”

Synergistic ameliorative effect of ascorbic acid and Moringa oleifera in lead-induced toxicity: a review

“…Findings from the studies of Yang et al, 2022 reported that a combination treatment comprising of western medicine, TCM and high doses of ascorbic acid resulted in the most effective outcome in the treatment of COVID-19. Idiopathic t h r o m b o c y t o p e n i c p u r p u r a w a s successfully treated with a combination of ascorbic acid and TCM (Hirano et al, 2007).…”