Dr. VIKRAM PABREJA
Director. PabCyte. Gurgaon. Haryana. India
Title: Treatment of Hypothyroidism with Intrathyroidal injection of Autologous PRP and Hyaluronic Acid
Biography
Biography: Dr. VIKRAM PABREJA
Abstract
This study was carried out to investigate the effects of intrathyroidal injection of Autologous PRP and HA under ultrasound guidance on Resident Thyrocyte Stem Cells and Thyrocyte Progenitor cells in the treatment of hypothyroidism (less T3 T4 TSH), subclinical hypothyroidism (normal T3 T4 raised TSH) and autoimmune thyroiditis. 30 patients were selected from age group of 25-70 years. All patients held oral thyroxine tablets prior to intrathyroidal injection of autologous PRP and HA. 20 ml Peripheral venous blood was withdrawn after pharmacologic intetvention with iv Omega 3 fatty acids 10% 5gm and iv ascorbic acid without preservative 5gm. Further it was centrifuged at 3300 rpm for 7 minutes to yield 6ml of PRP. This PRP was mixed with 1ml of Hyaluronic Acid, 22 mg/ml, non-avian & non-allergenic. PRP was tested for microbial contamination before injection. 3ml of PRP and 1ml of HA was injected in each lobe of thyroid gland under ultrasound guidance. The patients were followed up for a period of 1 year with 1 month, 3 months and 6 months and 1 year interval. Thyroid function Test, free T3, free TSH anti TPO, anti TG antibody tests were assessed along with ultrasound of thyroid gland. Of the 30 patients 12 were Males and 18 females. Females were categorized into 3 adoloscent (age 14-19 years)/TSH 7-15 micro IU/ml 10 (age 21-40 years)/TSH 10-30 micro IU/ml, 5 (Age 41-60 years)/TSH 8-16 micro IU/ml. A total of 3 injections were given at interval of 15 days. RESULTS 27 patients responded well to the treatment and improved after 1 month of injection. No adverse events were found during 1 year follow up with significant decrease in serum TSH, anti TPO and anti TG antibody values. T3 T4 increased in primary hypothyroidism situations. Patients reported less lethargy less musculoskeletal pains, better concertration, improved mood improvement in dry skin and hair loss and no weight gain from baseline. CONCLUSION It is evident that thyroid niche stem cells / Progenitor cells on stimulation have regenerative potential. Either new thyrocytes come up in the gland or earlier non functional or hypofunctioning thyrocytes get repaired and resume normal function. Thus intrathyroidal injection of autologous PRP and HA under ultrasound guidance can be a safe, better and effective therapy that can permanently rescue thyroid function. PRP and HA together act as a bioscaffold.