Is there an injection for thyroid
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Injection Treatments for Thyroid Conditions
Percutaneous Ethanol Injection (PEI) for Thyroid Nodules
Effectiveness of PEI in Benign Thyroid Nodules
Percutaneous ethanol injection (PEI) has been extensively studied as a treatment for benign thyroid nodules. Research indicates that PEI can significantly reduce the volume of benign solitary solid cold thyroid nodules. In a randomized trial, patients receiving a single intranodular injection of 98% ethanol experienced a median reduction in nodule volume of 47%, compared to just 9% in those treated with L-thyroxine (L-T4). This suggests that PEI is more effective than L-T4 in reducing nodule size.
PEI for Autonomous Thyroid Nodules
PEI has also been evaluated for autonomously functioning thyroid nodules. An Italian multicenter study involving 429 patients found that PEI was successful in normalizing thyroid hormone levels in 66.5% of patients with toxic adenomas and 83.4% of those with pretoxic adenomas. The treatment was particularly effective for nodules smaller than 15 mL, with a significant reduction in nodule size observed in all cases.
Long-Term Efficacy and Safety
Long-term studies have confirmed the efficacy and safety of PEI. A study with a four-year follow-up reported complete cure in 59% of patients and partial cure in 34%, with no recurrences observed. Another study with a five-year follow-up on cystic thyroid nodules showed a 91.9% reduction in nodule volume, with significant symptom improvement and minimal side effects.
Comparison of Single vs. Multiple Injections
A randomized trial comparing one injection to three weekly injections of ethanol found that both regimens were effective in reducing nodule volume, with no significant difference between the two strategies. However, the study noted that the procedure could be quite painful, and side effects such as transient thyrotoxicosis and facial dysesthesia were observed.
PEI for Recurrent Thyroid Carcinoma
PEI has also been explored as a treatment for recurrent papillary thyroid carcinoma. In a study involving 16 patients with recurrent lesions, PEI significantly reduced the median diameter of the lesions and was well-tolerated, with only mild local pain reported. This suggests that PEI could be a viable alternative for patients with recurrent thyroid cancer who are not candidates for surgery.
Subcutaneous Injection of Somatostatin Analogue
In addition to ethanol injections, subcutaneous injections of somatostatin analogues like SMS 201-995 have been studied for their effects on thyroid function. These injections have been shown to suppress thyroid-stimulating hormone (TSH) secretion in normal subjects, indicating potential for managing conditions related to TSH hypersecretion.
Conclusion
Percutaneous ethanol injection (PEI) is a highly effective and safe treatment for various thyroid conditions, including benign and autonomously functioning thyroid nodules, as well as recurrent thyroid carcinoma. While the procedure can be painful and has some side effects, its benefits in reducing nodule size and normalizing thyroid function make it a valuable alternative to surgery and radioiodine therapy. Subcutaneous injections of somatostatin analogues also show promise in managing thyroid-related conditions, although further research is needed to fully understand their potential.
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