Ehlers-Danlos syndrome Health Article

Definition

Ehlers-Danlos syndrome is a group of inherited disorders marked by extremely loose joints, hyperelastic skin that bruises easily, and easily damaged blood vessels.

Causes, incidence, and risk factors

There are six major types and at least five minor types of Ehlers-Danlos syndrome (EDS).

A variety of gene mutations (changes) cause problems with collagen, the material that provides strength and structure to skin, bone, blood vessels, and internal organs.

The abnormal collagen leads to the symptoms associated with EDS. In some forms of the condition this can include rupture of internal organs or abnormal heart valves.

Family history is a risk factor in some cases.

Symptoms

Symptoms of EDS include:

• Double-jointedness
• Easily damaged, bruised, and stretchy skin
• Easy scarring and poor wound healing
• Flat feet
• Increased joint mobility, joints popping, early arthritis
• Joint dislocation
• Joint pain
• Premature rupture of membranes during pregnancy
• Very soft and velvety skin
• Vision problems

Signs and tests

Examination by the health care provider may show:

• Deformed surface of the eye (cornea)
• Excess joint laxity and joint hypermobility
• Mitral valve prolapse
• Periodontitis
• Rupture of intestines, uterus, or eyeball (seen only in vascular EDS, which is rare)
• Signs of platelet aggregation failure (platelets do not clump together properly)
• Soft, thin, or very stretchy (hyperextensible) skin

Tests performed to diagnose EDS include:

• Collagen typing (performed on a skin biopsy sample)
• Collagen gene mutation testing
• Echocardiogram (heart ultrasound)
• Lysyl hydroxylase or oxidase activity

Treatment

There is no specific cure for Ehlers-Danlos syndrome. Individual problems and symptoms are evaluated and cared for appropriately. Frequently, physical therapy or evaluation by a doctor specializing in rehabilitation medicine is needed.

Expectations (prognosis)

People with EDS generally have a normal life span. Intelligence is normal.

Those with the rare vascular type of EDS are at significantly increased risk for rupture of a major organ or blood vessel. These individuals, therefore, have a high risk of sudden death.

Complications

Possible complications of Ehlers-Danlos syndrome include:

• Chronic joint pain
• Early-onset arthritis
• Failure of surgical wounds to close (or stitches tear out)
• Premature rupture of membranes during pregnancy
• Rupture of major vessels, including a ruptured aortic aneurysm (only in vascular EDS)
• Rupture of a hollow organ such as the uterus or bowel (only in vascular EDS)
• Rupture of the eyeball