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Symptoms of radiation damage
Medical expert of the article
Last reviewed: 04.07.2025
Acute radiation syndromes
Several different syndromes occur after whole body irradiation. These syndromes have three phases:
- prodromal phase (from 0 to 2 days after irradiation) with general weakness, nausea and vomiting;
- latent asymptomatic phase (1-20 days after irradiation);
- the acute phase of the disease (2-60 days after irradiation).
Acute radiation syndromes are classified by the main affected organ system. The higher the radiation dose, the more severe and faster the disease progresses. Symptoms and their dynamics after exposure to a radiation dose are characteristic of a certain dose, i.e. they can be used to assess the dose of ionizing radiation received.
Cerebral syndrome is caused by extremely high doses of whole-body irradiation (>10 Gy), and is always fatal. Symptoms begin within minutes to an hour after exposure. There is little or no latent phase, and the patient develops tremors, seizures, ataxia, cerebral edema, and death within hours or 1-2 days.
Gastrointestinal syndrome develops after whole-body irradiation with a dose >4 Gy, with gastrointestinal symptoms dominating. Pre-dormant symptoms are often severe, develop within 2-12 hours, and disappear within 2 days. The latent period is 4-5 days, during which the cells of the gastrointestinal mucosa die; this is accompanied by nausea, uncontrollable vomiting, and diarrhea, which lead to severe dehydration and electrolyte imbalance, decreased plasma volume, and vascular collapse. Intestinal necrosis may also develop, predisposing to bacteremia and sepsis. Fatal outcomes are observed quite often. Surviving patients are left with hematological syndrome.
Hematologic syndrome occurs after a whole-body dose of >2 Gy. A mild prodromal period may begin within 6-12 h and last 24-36 h. Bone marrow cells are damaged immediately, initially resulting in lymphopenia (maximum at 24-36 h). However, the patient is asymptomatic during a latent period of >1 week, other than decreased bone marrow function. Neutropenia (most noticeable at 2-4 weeks) and decreased antibody production lead to various infections, and thrombocytopenia, which develops within 3-4 weeks and may persist for many months, leads to petechiae and mucosal hemorrhages. Anemia develops slowly because preexisting red blood cells have a longer lifespan than white blood cells and platelets. Survivors have an increased incidence of leukemia.
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Local radiation damage
Radiation to almost any organ can result in acute and chronic adverse effects. For most patients, these are side effects of radiation therapy.