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- M Mahévas, S Audia, and J-F Viallard.
- Service de médecine interne, centre de référence des cytopénies auto-immunes de l'adulte, centre hospitalier universitaire Henri-Mondor, Assistance Publique-Hôpitaux de Paris, université Paris-Est-Créteil, Créteil, France. Electronic address: matthieu.mahevas@aphp.fr.
- Rev Med Interne. 2021 Jan 1; 42 (1): 46-49.
AbstractMultirefractory immune thrombocytopenia (ITP) is defined by the absence of response to TPO receptor agonists, rituximab and splenectomy (or contraindicated or refused) and the need of treatment. The approach to multirefractory ITP must be systematic and firstly involves reconsidering the diagnosis. Inherited thrombocytopenia, lymphoid hemopathies and myelodysplastic syndrome are the main causes to be mentioned. Multirefractory ITP is often associated with secondary ITP with signs of clinical or biological autoimmunity, monoclonal gammopathy of undetermined significance and a poor response to corticosteroids. Therapeutic management is complex and is based on the combination of treatments. New treatments are being developed.Copyright © 2020 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.
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