Acute radiation syndrome: Difference between revisions
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==Background== | ==Background== | ||
*Also called radiation poisoning, radiation toxicity, or radiation sickness. | *Also called radiation poisoning, radiation toxicity, or radiation sickness. | ||
*Acute illness caused by exposure to high doses (at least | *Acute illness caused by exposure to high doses (at least 1 Gy)<ref name="SNSRWG">Waselenko JK, MacVittie TJ, Blakely WF, et al. Medical management of the acute radiation syndrome: recommendations of the Strategic National Stockpile Radiation Working Group. Ann Intern Med. 2004 Jun 15;140(12):1037-51.</ref> of ionizing radiation over a short period of time. | ||
**1 Gray (Gy) = 100 rads | **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 Features== | ==Clinical Features== | ||
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==Clinical Course== | ==Clinical Course<ref name="SNSRWG" /><ref name="Donnelly">Donnelly EH1, Nemhauser JB, Smith JM, et al. Acute radiation syndrome: assessment and management. South Med J. 2010 Jun;103(6):541-6.</ref>== | ||
*ARS typically progresses through 4 stages of | *Each ARS syndrome typically progresses through 4 stages of disease | ||
===Prodromal Stage=== | ===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=== | ===Latent Stage=== | ||
*Short period of symptom improvement | |||
*Lasts several days to 1 month | |||
===Manifest Illness Stage=== | ===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=== | ===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== | ==Diagnosis== | ||
Revision as of 22:21, 12 July 2015
Background
- Also called radiation poisoning, radiation toxicity, or radiation sickness.
- Acute illness caused by exposure to high doses (at least 1 Gy)[1] 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 Features
Bone Marrow Syndrome
Gastrointestinal (GI) Syndrome
Cardiovascular (CV)/Central Nervous System (CNS) Syndrome
Clinical Course[1][2]
- 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.
Differential Diagnosis
Treatment
Disposition
- Admit
See Also
References
- ↑ 1.0 1.1 Waselenko JK, MacVittie TJ, Blakely WF, et al. Medical management of the acute radiation syndrome: recommendations of the Strategic National Stockpile Radiation Working Group. Ann Intern Med. 2004 Jun 15;140(12):1037-51.
- ↑ Donnelly EH1, Nemhauser JB, Smith JM, et al. Acute radiation syndrome: assessment and management. South Med J. 2010 Jun;103(6):541-6.