ДИАГНОСТИКА ХРОНИЧЕСКОГО ЛУЧЕВОГО СИНДРОМА НА РАННЕЙ СТАДИИ

Abstract

Purpose: To describe early symptoms of chronic radiation syndrome (CRS) which is of utmost importance for diagnosing this rare radiation pathology in man. 
 Material and methods: The paper presents the findings of retrospective analysis of early clinical manifestations of chronic radiation syndrome (CRS) based on the data of a long-term medical follow up of the residents of the Techa riverside communities. Mean doses of postnatal exposure to red bone marrow in patients with CRS calculated with TRDS-2016D were 698.8±18.2 mGy, maximum doses were 3 603.9 mGy.
 Results: Clinical picture of the CRS at the early stage was characterized by a set of non-specific changes including hematological, immune, neurological, and endocrine ones, as well as impairment of functions of a number of internal organs. The above-mentioned CRS symptoms developed in a certain sequence and depended on dose rate and absorbed dose to the organs. Prior to the development of a full-scale CRS clinical picture patients had a decrease in olfactory and taste thresholds, in vibration sensitivity, and changes in systemic immunity. Impairment of hematopoiesis, nervous and endocrine systems were also noted even at the early stage of CRS. Initial CRS changes were moderate and transient. The analysis of early CRS symptoms allows assuming that early CRS stage is a dysregulation pathology that is caused initially by radiation-induced disorders of immunohematopoiesis, nervous and endocrine systems. Visceral changes at the early CRS stage are secondary and functional. If exposure is terminated, they are reversible. However, if exposure continues at doses high enough to cause morphological changes in organs and tissues (dystrophy, fibrosis, hypoplasia, etc.), CRS course worsens and becomes irreversible.
 Conclusion: It was demonstrated that CRS diagnosis at the early stage is very complicated. The key issue is to analyze the relationship of specific CRS symptoms development and dose rate and absorbed organ doses.