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Romiplostim and eltrombopag, novel thrombopoietin receptor agonists, induce platelet proliferation and differentiation. They are indicated in splenectomised patients with chronic refractory ITP. Their adverse effects include gastrointestinal disorders, heart disease and thromboembolic events. Severe bleeding is treated with immunoglobulins achieving rapid but transient increases in platelets. Glucocorticoids are the first treatment choice.
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