Acute radiation syndrome

Background

• Also called radiation poisoning, radiation toxicity, or radiation sickness.
• Acute illness caused by exposure to high doses (at least 1 Gy) of ionizing radiation over a short period of time.
  • 1 Gray (Gy) = 100 rads
• Generally requires exposure of whole body (or most of the body)
• Fast-replicating cell lines most affected - GI, lymphohematopoietic, spermatocytes

Clinical Course

• Each ARS syndrome typically progresses through 4 stages of disease

Prodromal Stage

• Characterized by nausea and vomiting
  • Other symptoms include: malaise, fever, conjunctivitis
• Occurs within 48h-6d of exposure (at higher doses, can begin within minutes)
• Lasts up to 2 days

Latent Stage

• Short period of symptom improvement
• Lasts several days to 1 month

Manifest Illness Stage

• Manifestation of symptoms of clinical syndromes
• Severity based on, among other things:
  • Overall dose
  • Irradiated body volume
  • Comorbidities and overall health status
  • Age
• Characterized by significant immunosuppression
• Lasts for days to months

Recovery or Death

• If pt survives manifest illness stage, recovery is slow (weeks to years)
• If lethal dose received, death can occur within days (very high, rapid doses) or may be delayed up to several months

Diagnosis

• Clinical diagnosis, based on history and physical.

Disposition

• Admit

See Also

• Radiation exposure (clinical)
• Radiation exposure (disaster)
• Disaster medicine