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Ehlers-Danlos syndrome hypermobility type is associated with rheumatic diseases

updated

Tags: diagnosis, bad news, etiology, inflammation, arthritis, fibromyalgia, pro, pain problems, aging, chronic pain

Four articles on PainSci cite Rodgers 2017: (1) The Complete Guide to Trigger Points & Myofascial Pain(2) 34 Surprising Causes of Pain(3) Poisoned by Massage(4) Does Fascia Matter?

PainSci notes on Rodgers 2017:

People with the hypermobility-type Ehlers–Danlos syndrome (hEDS) may also have signs of rheumatological conditions. This study investigated medical records to look for correlations, and found them. The more carefully hEDS patients had been investigated, the more rheumatological signs were found. Most notably, “The HLA-B27 antigen was more prevalent” in hEDS patients who had received complete rheumatological workups. “HEDS is associated with complicated rheumatological conditions, which are uncovered by comprehensive workup.”

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

We retrospectively analyzed electronic medical records of patients with Ehlers-Danlos Syndrome hypermobility type (HEDS), including demographic information, workup, rheumatological diagnoses in order to determine its association with rheumatological conditions. HEDS Patients were stratified according to level of workup received (no additional work (physical exam only) = NWU, limited workup = LWU, comprehensive workup = CWU)). HEDS patients were predominantly female (21:4, F:M). The percentage of patients with at least one rheumatological condition was significantly correlated with level of workup (NWU, 9.2%; LWU, 33.3%, CWU, 67.1%; p-value < 0.0001). The HLA-B27 antigen was more prevalent (p-value < 2.2 × 10(-8)) in the CWU HEDS patients (23.9%) than in the general population of the United States (6.1%). HEDS with CWU were associated with more rheumatological conditions (i.e. psoriasis, ankylosing spondylitis, rheumatoid arthritis, fibromyalgia) than those with NWU or LWU. In conclusion, HEDS is associated with complicated rheumatological conditions, which are uncovered by comprehensive workup. These conditions require different clinical management strategies than HEDS, and left untreated could contribute to the pain or even physical disability (i.e. joint erosions) in HEDS patients. While the mechanisms underlying these associations are unknown, it is important that all HEDS patients receive adequate workup to ensure a complete clinical understanding for the best care strategy possible.

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