[Immune thrombocytopenias: pathophysiology and treatment].

Immune thrombocytopenia (ITP) is characterized by platelet destruction due to the presence of platelet antibodies. This phenomenon is associated with impaired platelet production by bone marrow. Short-course corticosteroids and high-dose intravenous immunoglobulins remain the first-line treatments. Several international guidelines propose splenectomy as a second-line treatment for chronic ITP. However, new therapeutic strategies including anti-CD20 monoclonal antibodies and thrombopoietin receptor agonists, appear to be very effective and to have good short-term tolerability. Prospective studies that include safety, efficacy and medico-economic assessments are needed to refine the management of chronic ITP.