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Multi-organ involvement and failure in a radiation accident: the Chinese experience of 1963

Department of Radiation Medicine and Clinical Hematology, North Taiping Road Hospital, Beijing 100039, PR China

In 1963, six cases of acute radiation sickness resulting from an accidental non-uniform ⁶⁰Co -ray irradiation of approximately 10 Ci were treated first in Hefei, Anhui province, and were then transferred to our hospital. The whole body average doses were estimated to be 2 x 10² cGy to 8 x 10³ cGy. Two of patients died of intestinal acute radiation sickness within 2 weeks. Autopsy findings revealed findings consistent with multi-organ failure. Four cases survived, and one of them recovered from septicaemic shock. Loss of hair, systemic infection, high fever and bleeding occurred in five cases. The essential therapeutic measures were strict isolation, preventive treatment with anti-infection drugs, fresh blood transfusion and sometimes infusion of formed blood elements. Among the survivors, two cases received homologous bone marrow transfusion. The general conditions of four cases followed-up for a period of 24–40 years are apparently good, with transparent lens, normal thyroid function and normal immunological reactions, except one patient who had a low serum immunoglobulin G level. Three cases showed subnormal adrenocortical activity and impairment of sex gland function. Patient A died from a car accident 24 years after the radiation accident. Patient C gave birth to a daughter and a son; the latter had severe mental retardation. Serial electroencephalographic changes occurred only in those cases who received high cranial doses. In all the cases, persistence of chromosome aberrations in peripheral lymphocytes was observed. Owing to local high doses, the remote regional effects led to amputation of one leg in patient D and to pathological fracture of the femur in patient A.