Symptoms in various forms of radiation sickness

Radiation damage can be associated with the ingress of rays as a result of external action, or with the penetration of radiation substances directly into the body. In this case, the symptoms of radiation sickness can be different - it depends on the type of rays, dosage, scale and location of the affected surface, as well as on the initial state of the organism.

External lesion of a significant surface of the trunk with a dosage of 600 roentgen is considered lethal. If the lesion is not so intense, then there is an acute form of radiation sickness. Chronic form is a consequence of repeated external influences, or additional damage with internal penetration of radiation substances.

[1], [2], [3], [4],

Chronic radiation sickness

Chronic flow occurs when repeated exposures to humans of small doses of external radiation, or with prolonged exposure to small amounts of radiation components that have penetrated into the body.

The chronic form is not detected immediately, since the symptoms of radiation sickness increase gradually. Such a flow is also subdivided into several degrees of complexity.

• I Art. - characterized by the appearance of irritability, insomnia, worsening concentration of attention. It happens that patients do not complain at all. Medical examinations indicate the presence of vegetative-vascular disorders - it can be cyanosis of limbs, instability of cardiac activity, etc. The blood test shows small changes: a slight decrease in the level of leukocytes, moderate thrombocytopenia. Such signs are considered reversible, and upon the termination of the action of radiation gradually self-disengage.
• II century. - is characterized by functional disorders in the body, and these disorders are more pronounced, stable and numerous. Patients complain of constant headache, fatigue, sleep disorders, memory problems. The nervous system suffers: polyneuritis, encephalitis, and other similar lesions develop.

Violated heart activity: the rhythm of the heart slows down, the tones are muffled, blood pressure drops. Vessels become more permeable and brittle. Mucous membranes atrophy and dehydrate. There are problems with digestion: appetite worsens, indigestion, diarrhea, attacks of nausea, disturbed peristalsis.

Due to damage to the "pituitary-adrenal gland" system, patients lose libido, metabolism worsens. Skin diseases develop, the hair becomes brittle and falls out, the nails crumble. There may be musculoskeletal pain, especially at high ambient temperatures.

The function of hematopoiesis worsens. Significantly reduced levels of leukocytes and reticulocytes. Blood coagulation is still normal.

• III century. - the clinical picture becomes brighter, organic lesions of the nervous system are observed. Disturbances resemble signs of intoxication encephalitis or myelitis. Often there is bleeding of any localization, with delayed and complex healing. There is a lack of blood circulation, blood pressure is still low, the functions of the endocrine system are violated (in particular, the thyroid gland and adrenal glands suffer).

[5], [6], [7], [8]

Symptoms in various forms of radiation sickness

There are several forms of the disease, depending on which organ system is affected. In this case, the damage to one or another organ directly depends on the radiation dose for radiation sickness.

• The intestinal form appears when the dose is 10-20 Gy. At the beginning, symptoms of acute poisoning, or radioactive enterocolitis, are observed. In addition, the temperature rises, muscles and bones ache, general weakness grows. Simultaneously with vomiting and diarrhea, symptoms of dehydration, asthenohypodina, cardiovascular disorders progress, attacks of an excited state, sopor appear. The patient may die after 2-3 weeks from cardiac arrest.
• The toxicity form occurs when the dose is 20-80 Gy. This form is accompanied by intoxication-hypoxic encephalopathy, which develops due to the disorder of cerebral dynamics of cerebrospinal fluid and toxemia. Symptoms of radiation sickness consist of progressive signs of hypodynamic asthenic syndrome and insufficiency of cardiac activity. You can observe a significant primary erythema, a progressive lowering of blood pressure, a collapoid state, a violation or absence of urination. After 2-3 days, the level of lymphocytes, leukocytes, and platelets drops sharply. With the development of a coma, the victim may die after 4-8 days.
• The cerebral form develops when the dose is more than 80-100 Gy. There is a defeat of neurons and vessels of the brain with the formation of severe neurological symptoms. Immediately after radiation damage, vomiting appears with a passing loss of consciousness in the 20-30 minute. After 20-24 hours, the number of agranulocytes decreases sharply and the lymphocytes in the blood completely disappear. Subsequently, excitation of psychomotorics, loss of orientation, convulsive syndrome, disturbances of respiratory function, collapse and coma are observed. Lethal outcome can come from respiratory paralysis in the first three days.
• The cutaneous form is expressed in the form of a burn shock state and an acute form of burn intoxication with the probability of suppuration of damaged skin. The shock state is formed as a result of strong irritation of skin receptors, destruction of blood vessels and skin cells, as a result of which trophic tissue and local metabolic processes are disrupted. Mass loss of fluid due to disruption of the vasculature leads to increased blood thickening and lowering of blood pressure.

As a rule, with dermal form, a lethal outcome can occur as a result of violation of barrier skin protection.

• Bone marrow forms when general radiation is received in a dose of 1-6 Gy, and mainly hematopoietic tissue is affected. There is an increased permeability of the walls of the vessels, a disorder of the regulation of the vascular tone, hyperstimulation of the vomiting center. Attacks of nausea and vomiting, diarrhea, pain in the head, weakness, inactivity, drop in blood pressure are standard symptoms of radiation damage. The analysis of peripheral blood indicates a decreased number of lymphocytes.
• The lightning-fast form of irradiation also has its clinical features. A characteristic feature is the development of a collapoid state with loss of consciousness and a sudden drop in blood pressure. Often the symptomatology is indicated by a shock-like reaction with a pronounced drop in pressure, swelling of the brain, and urination disorder. Attacks of vomiting and nausea are permanent and multiple. Symptoms of radiation sickness develop rapidly. This condition requires emergency medical care.
• The manifestation of radiation sickness in the oral cavity can occur after a single lesion with rays in a dose of more than 2 Gy. The surface becomes dry, rough. The mucous membrane is covered with pinpoint hemorrhages. The oral cavity becomes opaque. Disturbances of the digestive system and cardiac activity gradually adjoin.

Subsequently, the mucous in the mouth swells, there are ulcers and areas of necrosis in the form of light spots. Symptoms develop gradually, for 2-3 months.

Degrees and syndromes of radiation sickness

Acute radiation sickness occurs with a systemic single exposure to radiation with an ionizing dose of more than 100 roentgens. By the number of striking rays, 4 degrees of radiation sickness are divided, namely, the acute course of the disease:

• I Art. - lightened, with a dosage of 100 to 200 roentgens;
• II century. - medium, with a dosage of 200 to 300 roentgens;
• III century. - heavy, at a dosage of 300 to 500 roentgens;
• IV century. - very heavy, dosage is more than 500 roentgens.

The acute course of the disease is notable for its cyclicity. Separation in cycles determines the periods of radiation sickness - these are different between each other, time intervals, one after another, with different symptoms, but with some characteristic features.

• In the period of the primary reaction, the first signs of radiation damage are observed. This can occur as a few minutes after the radiation, and after a few hours, depending on the amount of damaging radiation. The period lasts from 1-3 hours to 48 hours. The disease manifests itself as general irritability, overexcitation, headache, sleep disturbance, dizziness. Less common may be apathy, general weakness. Appetite disorder, dyspeptic disorders, nausea, dry mouth, taste change are noted. If the radiation is significant, then there is a constant and uncontrollable vomiting.

Disorders of the autonomic nervous system are expressed in cold sweating, reddening of the skin. Quite often there is a shiver of fingers, tongue, eyelids, increased tendon tendon. The heart rate is slowing or becoming worse, the rhythm of the heart activity may be disturbed. The arterial pressure is unstable, the temperature can be raised to 39 ° C.

The urinary and digestive system also suffers: there are pains in the abdomen, in the urine are found protein, glucose, acetone.

• The latent period of radiation sickness can last from 2-3 days to 15-20 days. At the same time, it is considered that the less prolonged this period, the worse the forecast. For example, with grade III-IV disease, this stage is often absent. With easy flow, the latent period can result in the patient recovering.

That is characteristic for the latent period: the condition of the victim considerably improves, it considerably calms down, the sleep and temperature indicators are normalized. There is a premonition of an early recovery. Only in severe cases, drowsiness, dyspepsia and eating disorders may persist.

Nevertheless, a blood test taken during this period indicates further progression of the disease. The level of leukocytes, lymphocytes, erythrocytes, platelets and reticulocytes decreases. The function of the bone marrow is suppressed.

• In the peak period, which can last for 15-30 days, the patient's condition deteriorates sharply. Back pain in the head, insomnia, apathy. The temperature increases again.

From the second week after irradiation, hair loss, desiccation and peeling of the skin are noted. The severe course of radiation sickness is accompanied by the development of erythema, bladder dermatitis and gangrenous complications. Mucous membranes of the oral cavity are covered with ulcers and necrotic areas.

On the skin integument there are numerous hemorrhages, and in cases of severe damage there is bleeding in the lungs, digestive system, kidneys. Heart and vascular system suffers - there is an intoxication dystrophy of a myocardium, a hypotension, an arrhythmia. With hemorrhage in the myocardium, the symptomatology resembles the phenomena of an acute myocardial infarction.

The defeat of the digestive tract gives out a dry tongue with a dark or gray coating (sometimes brilliant, bright), signs of gastritis or colitis. Liquid frequent diarrhea, ulcers on the surface of the stomach and intestines can trigger dehydration, exhaustion of the patient.

Violated haematopoietic function, suppressed hematopoiesis. The number of blood components decreases, their level falls. The duration of bleeding increases, blood coagulability worsens.

Immune defenses of the body fall, which leads to the development of inflammatory processes, for example, sepsis, tonsillitis, pneumonia, oral cavity, etc.

• At the onset of the resolution period, one can speak of a positive course of the disease. This period lasts longer than the others - about 8-12 months, which depends on the dose of radiation received. The blood picture is gradually restored, the symptoms are smoothed.

[9], [10], [11]

Consequences and complications of radiation sickness

It is likely the emergence of consequences in patients who have suffered radiation sickness. The heaviest of them are:

• exacerbation of latent chronic infectious diseases;
• pathology of blood (leukemia, anemia, etc.);
• cataract;
• opacity of the vitreous humor;
• dystrophic processes in the body;
• impairment of the functionality of the reproductive system;
• genetic anomalies in subsequent generations;
• development of malignant neoplasms;
• death.

With a small degree of damage recovery occurs in about 2-3 months, however, even though the blood levels stabilize and the digestive disorders are stabilized, there are consequences in the form of severe asthenia, which makes the patients disabled for about six months. Complete rehabilitation in these patients occurs after many months, and sometimes years.

With an easy flow, blood counts come back to normal at the end of the second month.

Symptoms of radiation sickness and its further outcome depends on the severity of radiation damage, as well as on the timeliness of the provision of medical care. Therefore, if you suspect an irradiation, you should always consult a doctor.

[12], [13], [14], [15],