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Diagnosis of radiation damage
Last reviewed: 04.07.2025
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Following acute irradiation, laboratory testing is performed, including CBC, blood chemistry, and urinalysis. Blood type, compatibility, and HLA antigens are determined in case of blood transfusions or, if necessary, stem cell transplantation. Lymphocyte counts are performed 24, 48, and 72 hours after irradiation to assess the initial radiation dose and prognosis. Clinical blood tests are repeated weekly. This is necessary to monitor bone marrow activity and, if necessary, depending on the clinical course.
Local radiation injuries*
Irradiated tissue |
Side effects |
Brain |
See the relevant section |
Cardiovascular system |
Chest pain, radiation pericarditis, radiation myocarditis |
Leather |
Local erythema with intense burning or tingling, xerosis, keratosis, telangiectasia, vesicles, hair loss (within 5-21 days after irradiation). Dose >5 Gy: wet gangrene, ulceration. Late effects: progressive fibrosis, squamous cell carcinoma |
Sex glands |
Dose <0.01-0.015 Gy: suppression of spermatogenesis, amenorrhea, decreased libido. Dose 5-6 Gy: infertility |
Head and neck |
Inflammation of the mucous membrane, dysphagia, thyroid cancer |
Musculoskeletal system |
Myopathy, neoplastic changes, osteosarcoma |
Eyes |
Dose 0.2 Gy: cataract |
Lungs |
Radiation pneumonitis. Dose >30 Gy: fatal pulmonary fibrosis in some cases |
Kidneys |
Decreased glomerular filtration rate, decreased renal tubular function. Large doses (latency period from 6 months to 1 year): proteinuria, renal failure, anemia, arterial hypertension. Cumulative dose >20 Gy in <5 weeks: radiation fibrosis, oliguric renal failure |
Spinal cord |
Dose >50 Gy: myelopathy, neurological dysfunction |
Fetus |
Growth retardation, congenital malformations, inborn errors of metabolism, cancer, embryonic death |
*Primarily from radiation therapy.
Relationship between lymphocyte count at 48 h, radiation dose and prognosis*
Lowest lymphocytes, cells/mcl |
Radiation dose, Gy |
Forecast |
1500 (norm) |
0.4 |
Great |
1000-1499 |
0.5-1.9 |
Good |
500-999 |
2.0-3.9 |
Unclear |
100-499 |
4.0-7.9 |
Bad |
<100 |
8.0 |
Almost always fatal |
*Whole body irradiation (approximate doses).
Contamination. For radionuclide exposure, the entire body is examined with a Geiger counter to detect external contamination. To detect internal contamination, the nostrils, ears, mouth, and wounds are wiped with wet swabs, which are then tested with a counter. Urine, feces, and vomit must also be tested for radioactivity.
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