Radiation sickness is the set of symptoms that occur following exposure to high doses of ionizing radiation. Generally, the exposure must take place in a short period of time. Also known as acute radiation syndrome OR radiotoxemia.
For radiation sickness to occur, the doses received must be large and belong to the penetrating radiation group. That is, those that have the ability to reach internal organs. At the same time, when we talk about a short period of time, we mean just a few minutes in nuclear explosions or a few weeks under other circumstances.
Scientist Marie Curie died in 1934 of radiotoxemia. She suffered one of her most serious complications: spinal cord aplasia.
Clinical picture of radiation sickness
radiation sickness develops in 4 clinical stages which have variable duration and intensity:
- Healing or death.
The chances of experiencing symptoms increase as the dose is greater than 0.7 grams. The cause of death, as we will discuss later, is associated with severe infection or bone marrow destruction. Dehydration with fluid and electrolyte imbalance and coma can also occur in the process.
The severity of the consequences It depends on the degree of exposure and the dose that it has been received. As well as the body part that was exposed.
1. Prodromal phase of acute radiation syndrome
The first symptoms of radiation sickness they are usually the following:
- Lack of appetite.
- Nausea and vomit.
- Tiredness and extreme fatigue.
Swelling and edema, dizziness, tachycardia, irritability and insomnia can also be recorded. These symptoms occur within minutes after exposure to several days or weeks later.
Radiation damage to the skin usually manifests itself as redness and swelling. There will be blisters and ulcers, as happens with heat burns.
This first phase tends to disappear within a week. Therefore, it gives the false belief that there is no longer any danger from radiation. However, it is very likely that the same symptoms or new symptoms will appear sometime later.
2. Latency phase of radiotoxaemia
During the latency stage there are usually no symptoms of radiation sickness or they tend to be very mild. It can last from the first week of exposure up to 21-30 days after.
Symptoms will tend to come back and get worse. Cell death is happening at this point in the process. from the bone marrow.
3. Manifest clinical stage of radiation sickness
Subsequently, hair loss, impaired fertility may occur and, more seriously, the affectation of the hematopoietic systems, gastrointestinal, cardiovascular and neurological. Signs of the central nervous system and digestive system are usually as follows:
- loss of appetite
- Vomiting preceded by nausea.
When there is bone marrow destruction, the hematopoietic syndromecharacterized by pancytopenia, or a decrease in all three types of blood cells, with anemia (red blood cells), leucopenia (white blood cells) and thrombocytopenia (platelets).
Thrombocytopenia carries with it the risk of bleeding. Meanwhile, leukopenia increases the chance of infections due to immunosuppression.
4. Final stage
The critical stage of radiation sickness occurs between the second and seventh weeks after exposure. Here healing or death occurs.
Total marrow aplasia (manifested by pancytopenia), prolonged coma, loss of GI tract motility, spontaneous abortions, and infertility are usually present.
Diagnosis is clinical and excludes other conditions.
The diagnosis of radiation sickness is clear when there is a previous event of exposure. It can occur after nuclear accidents (something very rare today), but also how consequence of long-term treatments for cancer, such as breast. Or even in workplaces where nuclear power is handled.
There is no specific treatment for radiation sickness.
Treatment focuses on resolving symptoms, therefore it must be individualized according to each case. It tends to focus on dealing with infections, wounds and burns, while maintaining hydration. Antibiotics, antiemetics and sedatives are prescribed.
When there is bone marrow involvement, treatments should be more intense and include factors that stimulate the hematopoietic lineage. This is because the leading cause of death in radiation sickness is internal bleeding due to lack of platelets and infections due to lack of white blood cells.
Plasma and blood transfusions, surgery for burns, and, in some cases, protocols for radiation-induced leukemia may be required.
Bone marrow transplant is an option. On the other hand, in cases of infertility due to ovarian and testicular dysfunction, there is no effective treatment.
A disease with long-term effects
Radiation sickness is very rare and it is produced, above all, by extreme situations, such as a nuclear explosion or accidents in nuclear power plants. However, there are milder consequences that are present in the context of everyday situations, such as cancer treatment or performing certain tasks.
Healing of the skin and bone marrow can take weeks to years. In addition to level accumulation of radiation It can increase your risk of cancer later in life.
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