Acute Radiation Syndrome

Acute Radiation Syndrome

Article
Brain & Nerve
Digestive Health
+3
Contributed byMaulik P. Purohit MD MPHApr 04, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • ARS (Acute Radiation Syndrome)
  • Radiation Disease
  • Radiation Illness

What is Acute Radiation Syndrome? (Definition/Background Information)

  • Acute Radiation Syndrome (ARS) is described as the harmful effects that are caused by acute ionizing radiation exposure. Usually, a large dose of radiation exposure is the biggest concern for this condition, because it is more likely to cause immediate, adverse health effects
  • There are 3 potential stages to Acute Radiation Syndrome
    • The first stage is called the prodromal stage and displays hallmark symptoms, such as nausea and vomiting, which may last for a few minutes to a few days
    • The latent stage follows this prodromal stage and the individual appears to have improved and is healthy. This stage may last for a few hours to a few weeks
    • The final stages manifest the illness; the signs and symptoms are specific to each body system that is affected. The major organ system that can be involved include the cardiovascular and central nervous system (that can cause death within 3 days), the gastrointestinal system, and the hematopoietic (bone marrow) system, which arise due to high doses of radiation
  • Any individual can be affected by Acute Radiation Syndrome; but, individuals who work in certain radiation facilities or are undergoing treatment with radioactive material are at a higher risk for developing the condition
  • A healthcare professional can diagnose the condition through a physical exam and a Geiger counter test to measure radiation levels, along with other techniques
  • It is important to note that damage due to radiation is irreversible, and there is no treatment to repair the damaged cells. However, treatment to reduce further damage from radiation is available and will be best determined by a healthcare professional
  • The prognosis for Acute Radiation Syndrome is dependent on factors, such as the measure of radiation dose exposure and parts/systems of the body that are affected. It is generally difficult to predict the outcome. Complications, such as infections, can worsen the outcome

Who gets Acute Radiation Syndrome? (Age and Sex Distribution)

  • Individuals at any age in life may be affected by Acute Radiation Syndrome
  • Males and females of different racial and ethnic backgrounds are equally affected by the condition

What are the Risk Factors for Acute Radiation Syndrome? (Predisposing Factors)

The risk factors for Acute Radiation Syndrome may include:

  • Working in facilities that use radioactive materials or equipment including industrial and healthcare fields
  • Undergoing treatment involving radiation exposure

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Acute Radiation Syndrome? (Etiology)

Acute Radiation Syndrome is caused by the following factors:

  • Exposure to ionizing radiation that may come from:
    • High energy X-rays used in diagnosis and therapy
    • Radiation inside nuclear reactors, cyclotrons, linear accelerators, alternating gradient synchrotrons, and sealed cobalt
    • Cesium sources for cancer therapy
  • Cardiovascular and central nervous system sickness is caused by exposure to high doses of radiation that are greater than 3000 rads
  • Gastrointestinal sickness is caused by radiation exposure of 400 rads or more
  • Hematopoietic sickness is caused by radiation exposure between 200-1000 rads

What are the Signs and Symptoms of Acute Radiation Syndrome?

The signs and symptoms of Acute Radiation Syndrome may vary between individuals. The hallmark signs and symptoms of ARS may include:

  • Nausea, vomiting, and diarrhea
  • Anorexia and malaise (general feeling of discomfort)
  • Headache
  • Tachycardia or rapid heartbeat

Severe signs and symptoms of cardiovascular and central nervous system sickness causing significant damage include:

  • Anxiety, confusion, and loss of consciousness in the prodromal stage along with the hallmark symptoms
  • Tremors and convulsions within 5 to 6 hours
  • It can result in death within 72 hours following exposure

Gastrointestinal sickness may include signs and symptoms such as:

  • The hallmark symptoms being difficult to control, electrolyte imbalance, and dehydration
  • Diminished plasma volume and blood vessel collapse
  • Infection

Hematopoietic sickness may include signs and symptoms such as:

  • Hallmark symptoms along with a lack of appetite (anorexia) and fever
  • Spleen, lymph node, and bone marrow degeneration which leads to lymphopenia (lack of lymph cells)
  • Higher likelihood of infection

How is Acute Radiation Syndrome Diagnosed?

A healthcare professional can diagnose Acute Radiation Syndrome through:

  • Analysis of previous medical history and a physical exam
  • Evaluation of a history of radiation exposure
  • Analyzing when vomiting occurred in relation to the initial exposure
  • Use of Geiger counters to measure radiation levels of the body

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Acute Radiation Syndrome?

Complications of Acute Radiation Syndrome are difficult to predict but may include:

  • Higher risk for infections due to lower lymph cell count
  • Death may result from an acute exposure to radiation

How is Acute Radiation Syndrome Treated?

There is no way to reverse the damage caused by radiation to the cells.

  • Treatment for the cardiovascular and central nervous system sickness is symptomatic
  • Treatment of other Acute Radiation Syndrome signs and symptoms will be determined by a healthcare professional

The following measures may be used in the treatment:

  • Washing the skin with agents that bind to radioactive material
  • Inducing vomiting to pump ingested radioactive material out of the body
  • Drugs that prevent vomiting (antiemetic), in some cases
  • Use of antibiotics
  • Platelet transfusions

How can Acute Radiation Syndrome be Prevented?

  • Acute Radiation Syndrome can be prevented by avoiding areas with a possibility of radiation exposure, such as nuclear reactors, when without proper protective equipment
  • Use of radiation protective clothing and gear, as required or recommended
  • Stopping treatment methods that use radiation
  • Enforcing strict adherence to statutory laws and regulations that govern the use of radioactive substances and radiation exposure

What is the Prognosis of Acute Radiation Syndrome? (Outcomes/Resolutions)

  • The prognosis of Acute Radiation Syndrome depends on the severity of the signs and symptoms. Mild conditions have better prognosis than ARS with severe signs and symptoms
  • Still, the outcome depends upon the amount of radiation one is exposed to, the duration of radiation, organ systems affected, severity of signs and symptoms, and overall health of individual
    • The prognosis of cardiovascular and central nervous system sickness is generally fatal
    • The prognoses of the other types of Acute Radiation Syndrome are dependent on the dose size, affected area, and when the treatment was started following exposure. It is typically difficult to predict the prognosis in such cases
  • Some individuals who have low dose exposure or only have a small part of their body affected, generally will have a better prognosis than those who are exposed to a high dose or have total body irradiation

Additional and Relevant Useful Information for Acute Radiation Syndrome:

  • Radiation dermatitis is skin condition that occurs due to exposure to ionizing radiation, commonly from radiation therapy. It may be classified as acute and chronic

The following article links are good sources for radiation dermatitis (both acute and chronic):

http://www.dovemed.com/diseases-conditions/acute-radiation-dermatitis/

http://www.dovemed.com/diseases-conditions/chronic-radiation-dermatitis/

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Maulik P. Purohit MD MPH picture
Approved by

Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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