Radiation-Exposure Injuries
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The tables below show the symptoms that manifest with localized cutaneous radiation injury, acute radiation syndrome, and lethal doses of radiation according to the Centers for Disease Control and Prevention. [1, 2]
Table 1. Clinical Symptoms of Localized Cutaneous Radiation Injury (Open Table in a new window)
Localized Cutaneous Injury
Clinical Symptoms
3 Gy
Hair loss
6 Gy
Burns
10-15 Gy
Dry desquamation
20-50 Gy
Wet desquamation
50 Gy
Cutaneous necrosis and ulceration
Table 2. Clinical Symptoms of Acute Radiation Syndrome (Open Table in a new window)
Acute Radiation Syndrome
Clinical Symptoms
>0.7 Gy
Hematopoietic syndrome – anemia, neutropenia
>10 Gy
Gastrointestinal syndrome – nausea, vomiting, dehydration, weight loss, anorexia, bloody diarrhea
>20 Gy
Cerebrovascular syndrome – cerebral edema, ataxia, hypotension, convulsions
Table 3. Clinical Symptoms of Whole Body Lethal Doses of Radiation (Open Table in a new window)
Lethal Doses
Clinical Symptoms
3.5 Gy
Lethal without treatment at 60 days
>7 Gy
Lethal with treatment at 60 days
>100 Gy
Lethal within hours
In March 2015, filgrastim (Neupogen) was approved by the US Food and Drug Administration (FDA) to increase survival in patients acutely exposed to myelosuppressive doses of radiation (suspected or confirmed exposure to radiation >2 Gy). [3, 4, 5]
A June 2015 update on radiation-related injuries and their management was published by Wunderle and Gill. [6]
See the image below.
For more information on radiation injuries and decontamination, see the Medscape topics CBRNE – Radiation Emergencies and External Decontamination for Radiation Exposure.
Centers for Disease Control and Prevention. Acute Radiation Syndrome: A Fact Sheet for Clinicians. Available at http://www.bt.cdc.gov/radiation/arsphysicianfactsheet.asp. Accessed: April 28, 2015.
Parikh JR, Geise RA, Bluth EI, Bender CE, Sze G, Jones AK, et al. Potential Radiation-Related Effects on Radiologists. AJR Am J Roentgenol. 2017 Mar. 208 (3):595-602. [Medline]. [Full Text].
Neupogen (filgrastim) [package insert]. Thousand Oaks, California: Amgen, Inc. March 2015. Available at [Full Text].
Singh VK, Hauer-Jensen M. γ-Tocotrienol as a Promising Countermeasure for Acute Radiation Syndrome: Current Status. Int J Mol Sci. 2016 May 3. 17 (5):[Medline]. [Full Text].
Singh VK, Romaine PL, Newman VL, Seed TM. Medical countermeasures for unwanted CBRN exposures: part II radiological and nuclear threats with review of recent countermeasure patents. Expert Opin Ther Pat. 2016 Dec. 26 (12):1399-1408. [Medline]. [Full Text].
Wunderle K, Gill AS. Radiation-related injuries and their management: an update. Semin Intervent Radiol. 2015 Jun. 32(2):152-62. [Medline].
Localized Cutaneous Injury
Clinical Symptoms
3 Gy
Hair loss
6 Gy
Burns
10-15 Gy
Dry desquamation
20-50 Gy
Wet desquamation
50 Gy
Cutaneous necrosis and ulceration
Acute Radiation Syndrome
Clinical Symptoms
>0.7 Gy
Hematopoietic syndrome – anemia, neutropenia
>10 Gy
Gastrointestinal syndrome – nausea, vomiting, dehydration, weight loss, anorexia, bloody diarrhea
>20 Gy
Cerebrovascular syndrome – cerebral edema, ataxia, hypotension, convulsions
Lethal Doses
Clinical Symptoms
3.5 Gy
Lethal without treatment at 60 days
>7 Gy
Lethal with treatment at 60 days
>100 Gy
Lethal within hours
Lars J Grimm, MD, MHS Assistant Professor, Department of Diagnostic Radiology, Duke University Medical Center
Disclosure: Nothing to disclose.
Edward B Holmes, MD, MPH, MSc Owner, Occupational Medicine and Medical Toxicology, Holmes Company Consulting, LLC; Chief Medical Consultant, Disability Determination Services for Social Security, State of Utah
Disclosure: Nothing to disclose.
Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Received salary from Medscape for employment. for: Medscape.
Zygmunt F Dembek, PhD, MPH, MS, LHD Associate Professor, Department of Military and Emergency Medicine, Adjunct Assistant Professor, Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, F Edward Hebert School of Medicine
Zygmunt F Dembek, PhD, MPH, MS, LHD is a member of the following medical societies: American Chemical Society, New York Academy of Sciences
Disclosure: Nothing to disclose.
Radiation-Exposure Injuries
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