Medical Radiology and Radiation Safety. 2022. Vol. 67. № 5

DOI: 10.33266/1024-6177-2022-67-5-47-51

N.A. Metlyaeva, A.Yu. Bushmanov, I.A. Galstyan,
M.V. Konchalovsky, O.V. Shcherbatykh, F.S. Torubarov

OUTCOME OF CHRONIC RADIATION SICKNESS
OF A SUBACCUTE COURSE TO HYPOPLASTIC ANEMIA

A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia

Contact person: N.A. Metlyaeva, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

Purpose: A retrospective analysis of the clinical observation of chronic radiation sickness (CRS) culminating in the development of aplastic anemia.

Material and methods: The object of the examination was the medical history of a 25-year-old man, an apparatchik at the Mayak Production Association, who worked under conditions of external exposure and internal intake of radionuclides from July 1948 to December 1949.

Results: When he was employed, he was practically healthy. During the work, according to the data of individual dosimetric control, he received external relatively uniform exposure in a total dose of 1.72 Gy. During the entire observation period (2 years 4 months) in the 2nd therapeutic department of the Medical Unit No. 71 (from 12/15/49 to 01/15/52) and then in a special clinic of the IBP of the Ministry of Health of the USSR (from 01/17/52 to 03/24/52). It was noted the excretion of radioactive substances in the daily urine 8.3‒28.3 Bq, in the feces – 13.3–1133.3 Bq, without a decrease in their number in subsequent studies. Sick since August 1949. Taking into account the professional history, the presence of sepsis, severe hemorrhagic syndrome, complete aplasia of the bone marrow, long-term carriage and release of radioactive substances, in 1952 the final clinical diagnosis was formulated: Chronic recurrent form of radiation injury due to ingestion of radioactive substances, in a state of exacerbation. Aplastic anemia. Septicopyemia. General hemorrhagic syndrome. Parenchymal changes in internal organs. Meningoencephalitis. Myocarditis. Left-sided pneumonia with pleurisy. Residual effects of subarachnoid hemorrhage. Trophic ulcers of the left buttock. Pyoderma with necrosis of both elbows. Infiltration of the upper third of the right thigh along the back surface. On March 24, 1952, the patient died. The clinical diagnosis fully coincided with the pathoanatomical diagnosis.

Conclusion: The case history of patient E. is a vivid illustration of the subacute course of CRS with a rapid lethal outcome. The presence of a significant internal intake of osteotropic radionuclides led to the predominance of destructive processes in the bone marrow over regenerative ones and, accordingly, predetermined the development of aplastic anemia with a fatal outcome.

Keywords: radionuclide incorporation, chronic radiation sickness, subacute course, agranulocytosis, anemic syndrome, aplastic anemia

For citation: Metlyaeva NA, Bushmanov AYu, Galstyan IA, Konchalovsky MV, Shcherbatykh OV, Torubarov FS. Outcome of Chronic Radiation Sickness of a Subaccute Course to Hypoplastic Anemia. Medical Radiology and Radiation Safety. 2022;67(5):47–51. (In Russian). DOI: 10.33266/1024-6177-2022-67-5-47-51

References

1. Guskova A.K. Chronic Radiation Sickness from Uniform Irradiation. Radiatsionnyye Porazheniya Cheloveka = Radiation Effects in Man. Ed. Barabanova A.V., Baranov A.Ye., Bushmanov A.Yu.. et al. Moscow, Slovo Publ., 2007. P. 85-101 (In Russian).

2. Kurshakov N.A. Clinic and Therapy of Radiation Sickness (1957). Izbrannyye Materialy «Byulletenya Radiatsionnoy Meditsiny» = Selected Materials of the Bulletin of Radiation Medicine. V. 1. Moscow, A.I. Burnasyan FMBC Publ., 2016. P. 183-201 (In Russian).

3. Vyalova N.A., Suvorova L.A., Ivanova T.A., et al. Features of hematopoiesis in the long term in patients with chronic radiation sickness. Izbrannyye Materialy «Byulletenya Radiatsionnoy Meditsiny» = Selected Materials of the Bulletin of Radiation Medicine. V. 1. Moscow, A.I. Burnasyan FMBC Publ., 2016. P. 408-420 (In Russian).

4. Pesternikova V.S. The State of Hematopoiesis in Patients with Chronic Radiation Sickness 25-30 Years after the Diagnosis of the Disease. Izbrannyye Materialy «Byulletenya Radiatsionnoy Meditsiny» = Selected Materials of the Bulletin of Radiation Medicine. V. 1. Moscow, A.I. Burnasyan FMBC Publ., 2016. P. 436-444 (In Russian).

5. Lemberg V.K., Aristov V.P., Bukhtoyarova Z.M., Nifatov A.P. The State of the Hematopoietic Bone Marrow in the Long-Term Period after Occupational Irradiation According to Pathoanatomical Autopsy Data. Izbrannyye Materialy «Byulletenya Radiatsionnoy Meditsiny» = Selected Materials of the Bulletin of Radiation Medicine. V. 2. Moscow, A.I. Burnasyan FMBC Publ., 2016. P. 684-690 (In Russian).

6. Yegorov A.P., Bochkarev V.V. Krovetvoreniye i Ioniziruyushchaya Radiatsiya = Hematopoiesis and Ionizing Radiation. Moscow, Medgiz Publ., 1954. 259 p. (In Russian).

7. Kurshakov N.A. Ostraya Luchevaya Bolezn = Acute Radiation Sickness. Moscow, Medgiz Publ., 1956. 15 p. (In Russian).

8. Glazunov I.S., et al. Clinic and Some Questions of the Pathogenesis of Neurological Disorders in Severe forms of Acute Radiation Sickness. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova = The Korsakov’s Journal of Neurology and Psychiatry. 1973;73;2:165-168 (In Russian).

9. Akleyev A.V. Khronicheskiy Luchevoy Sindrom u Zhiteley Pribrezhnykh Sel Reki Techa = Chronic Radiation Syndrome in Residents of the Coastal Villages of the Techa River. Chelyabinsk, Kniga Publ., 2012. 464 p. (In Russian).

10. Galstyan I.A., Metlyayeva N.A., Konchalovskiy M.V., et al. Subacute Course of Chronic Radiation Syndrome. Meditsina Truda i Promyshlennaya Ekologiya = Russian Journal of Occupational Health and Industrial Ecology. 2021;9:572-579. https://doi.org/10.31089/1026-9428-2021-61-9-572-579. (In Russian).

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Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 20.06.2022. Accepted for publication: 25.08.2022.