Subtle differences in autonomic symptoms in people diagnosed with hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorders

Am J Med Genet A. 2021 Jul;185(7):2012-2025. doi: 10.1002/ajmg.a.62197. Epub 2021 Apr 7.

Abstract

The hypermobile Ehlers-Danlos syndrome (hEDS) GENE study is a multicenter, cohort study with the goal to identify genes associated with hypermobile EDS. Of the 148 people enrolled in the hEDS GENE study, 98 meet the 2017 hEDS criteria, 27 have a hypermobility spectrum disorder (HSD) and 23 are asymptomatic family members. More than 80% of participants are female with an average age of 41 years. Each participant has completed seven questionnaires to quantify disease-related symptomatology. People with hypermobility experience a variety of physical and somatic symptoms, especially in the areas of fatigue, kinesiophobia, gastrointestinal, and autonomic function. These cause a significant decrease in health-related quality of life. The frequency and severity of most symptoms were indistinguishable between participants with hEDS and HSD; however, there were significant differences in autonomic symptoms. Less than 20% of participants had autoantibodies known to be associated with dysautonomia. Subtle symptomatic differences in people meeting the 2017 diagnostic criteria suggest focusing further etiologic studies on autonomic pathways.

Keywords: dysautonomia; fatigue; gastrointestinal; hypermobile Ehlers-Danlos syndrome (hEDS); kinesiophobia; pain.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Ehlers-Danlos Syndrome / diagnosis
  • Ehlers-Danlos Syndrome / epidemiology
  • Ehlers-Danlos Syndrome / genetics*
  • Ehlers-Danlos Syndrome / pathology
  • Fatigue / diagnosis
  • Fatigue / epidemiology
  • Fatigue / genetics*
  • Fatigue / pathology
  • Female
  • Humans
  • Joint Instability / diagnosis
  • Joint Instability / epidemiology
  • Joint Instability / genetics*
  • Joint Instability / pathology
  • Male
  • Primary Dysautonomias / diagnosis
  • Primary Dysautonomias / epidemiology
  • Primary Dysautonomias / genetics*
  • Primary Dysautonomias / pathology
  • Quality of Life
  • Surveys and Questionnaires
  • Young Adult