Acute radiation syndrome – Signs and Symptoms


Acute radiation syndrome (A.R.S.), which is also known as radiation sickness or radiation poisoning. Acute radiation syndrome is collection of health effects that are caused by being exposed to high amounts of amounts of ionizing radiation, in a short period of time. The symptoms of acute radiation syndrome can start within the hour of exposure, and can last for several months. Within the first few days the symptoms are usually nausea, vomiting and a loss of appetite. In the following few hours or weeks will be a few symptoms, which later become additional symptoms, after is either recovery or death.

Acute radiation syndrome involves a total dose of greater than 0.7 Gy (70 rads), that generally occurs from a source outside the body within minutes. Sources of such radiation can occur accidentally or intentionally.  They may involve nuclear reactors, cyclotrons, and certain devices used in cancer therapy. It is generally divided into three types; bone marrow, gastrointestinal, and neurovascular syndrome, with bone marrow syndrome occurring at 0.7 to 10 Gy, and neurovascular syndrome occurring at doses that exceed 50 Gy.  The cells that are most affected are generally those that are rapidly dividing. At high doses, this causes DNA damage that may be irreparable.  Diagnosis is based on a history of exposure and symptoms. Repeated complete blood counts (CBCs) can indicate the severity of exposure.

Treatment of acute radiation syndrome is generally supportive care.  This may include blood transfusions, antibiotics, colony-stimulating factors, or stem cell transplant. If radioactive material remains on the skin or in the stomach it should be removed.  If radioiodine was breathed in or ingested, potassium iodide may be recommended. Complications such as leukemia and other cancers among those who survive are managed as usual. Short term outcomes depend on the exposure dose.

ARS is generally rare. A single event, however, can affect a relatively large number of people.  Notable cases occurred following the atomic bombing of Hiroshima and Nagasaki and the Chernobyl nuclear power plant disaster.  ARS differs from chronic radiation syndrome, which occurs following prolonged exposures to relatively low doses of radiation.

Signs and symptoms

Classically acute radiation syndrome is divided into three main presentations: hematopoietic, gastrointestinal and neurological/vascular.These syndromes may or may not be preceded by a prodrome. The speed of onset of symptoms is related to radiation exposure, with greater doses resulting in a shorter delay in symptom onset. These presentations presume whole-body exposure and many of them are markers that are not valid if the entire body has not been exposed. Each syndrome requires that the tissue showing the syndrome itself be exposed. The gastrointestinal syndrome is not seen if the stomach and intestines are not exposed to radiation. Some areas affected are:

Hematopoietic.  This syndrome is marked by a drop in the number of blood cells, called aplastic anemia. 

Gastrointestinal. This syndrome often follows absorbed doses of 6–30 grays (600–3,000 rad). The signs and symptoms of this form of radiation injury include nausea, vomiting, loss of appetite, and abdominal pain.

Neurovascular. This syndrome typically occurs at absorbed doses greater than 30 grays (3,000 rad), though it may occur at 10 grays (1,000 rad). It presents with neurological symptoms such as dizziness, headache, or decreased level of consciousness, occurring within minutes to a few hours, and with an absence of vomiting. It is invariably fatal.

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