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Ehlers-Danlos syndrome
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'''Ehlers-Danlos syndromes''' (EDS) is a group of inherited disorders that affects [[Connective tissue|connective tissues]] β primarily skin, joints, and blood vessel walls.<ref>{{Cite news |url =http://www.mayoclinic.org/diseases-conditions/ehlers-danlos-syndrome/basics/definition/con-20033656 | title = Ehlers-Danlos syndrome - Symptoms and causes|work=Mayo Clinic|access-date=2018-08-17|language=en}}</ref> It is a genetic disease that causes a defect in the production and/or metabolism of [[collagen]] and other connective tissue abnormalities.<ref name=":2" /><ref name="Mao2002" /> It is characterized by joint hypermobility, skin hyperextensibility, and tissue fragility, and ranges widely in severity.<ref>{{Cite news |url =https://www.ehlers-danlos.com/what-is-eds/ | title = What are the Ehlers-Danlos Syndromes?|work=The Ehlers Danlos Society|access-date=2018-10-07|language=en-US}}</ref> == Symptoms and presentation == [[File:Hypermobile (double jointed) phalangeal joints.JPG|300px|thumb|right|An 18 years old patient with EDS can extend his fingers back to almost touching the forearm due to hypermobile [[phalangeal]] joints.]] Symptoms vary widely between individuals, based on the subtype of EDS they have. EDS affects connective tissues, which results in symptoms that range from mild joint effects to life-threatening complications.<ref name=":2" /> * [[joint hypermobility]] (stretch further than normal) * loose/unstable joints, prone to subluxations/dislocations * [[Arthralgia|joint pain]] * joints that move beyond the normal range (hyperextensibility) * early onset of [[arthritis]] * soft, velvety-like skin * fragile skin that tears or bruises easily * severe scarring * slow and poor wound healing * development of [[molluscoid psuedo tumors]] * [[Musculoskeletal system|musculoskeletal]] pain * poor [[muscle]] tone (less common) == Subtypes == <div style="max-width:270px;float:right;margin:0;padding-bottom: 3em;clear:both"> <gallery style="font-size:1.em;margin:0;padding:0;" widths="350" mode="slideshow"> File:Beighton Score - Thumb Reaches Forearm.JPG|Hypermobile EDS, cEDS, and clEDS can be diagnosed using [https://www.ehlers-danlos.com/assessing-joint-hypermobility/ The Beighton Scoring System] along with [https://www.ehlers-danlos.com/eds-types/ EDS Types] criteria. Here, thumb reaches forearm in one of its measurements|alt= File:PMC3504533 1471-2415-12-47-2 (cropped).png|Hyperelastic skin in a person with cEDS|alt= File:PMC3567970 1752-1947-7-35-1 (cropped).png|Translucent skin in Vascular EDS (VEDS)|alt= File:751768.fig.002a.jpg|Atrophic scar found in cEDS, clEDS, Dermatosparaxis, and some other types|alt= File:Marfan.JPG|"Marfanoid habitus" (resembling Marfans Syndrome) long slender fingers of Kyphoscoliosis Type EDS|alt= File:Ehlers-danlos.png|4 y/o diagnosed by swelling of eyelids, corneas protruded anteriorly, blue sclerae, high myopia, and keratoconus. EDS, Rare Types: Brittle Cornea Syndrome (BCS)|alt= </gallery> </div> There are currently thirteen sub-types of EDS. These include six distinct types of EDS and sub-types, as well as five presentations that fit into an 'other' category.<ref name=":1">{{Cite web | url = https://rarediseases.info.nih.gov/diseases/6322/ehlers-danlos-syndromes | title = Ehlers-Danlos syndromes|website =Genetic and Rare Diseases Information Center|language=en|access-date=2018-10-06}}</ref><ref name=":0">{{Cite news |url =http://ehlers-danlos.com/eds-types/ | title = The Types of EDS|work=The Ehlers Danlos Society|access-date=2018-08-17|language=en-US}}</ref><ref name=":2" /> They are: * [https://rarediseases.info.nih.gov/diseases/2081/ehlers-danlos-syndrome-hypermobility-type Hypermobile EDS] (hEDS) - the most dominant clinical manifestation; presents with joint hypermobility, resulting into dislocations, [[bruising]] and [[chronic pain]], often out of proportion to physical and radiological findings. *[https://rarediseases.info.nih.gov/diseases/2088/ehlers-danlos-syndrome-classic-type Classical (cEDS)] and [https://www.ehlers-danlos.com/eds-types/#clEDS Classical-like (clEDS)] presents with marked skin hyperextensibility, joint hypermobility, and in clEDS easy [[bruising]]. *[https://rarediseases.info.nih.gov/diseases/2082/ehlers-danlos-syndrome-vascular-type Vascular EDS (VEDS)] and [https://www.ehlers-danlos.com/eds-types/#cvEDS Cardiac-valvular EDS (cvEDS)] - presents with arterial/intestinal/uterine fragility with possibility of arterial or organ rupture; often presents with thin or translucent skin with veins being visible thru the skin and in cvEDS severe progressive cardiac-valvular problems. *[https://rarediseases.info.nih.gov/diseases/2083/ehlers-danlos-syndrome-kyphoscoliosis-type Kyphoscoliosis Type] - presents with scoliosis, joint laxity, and severe muscle hypotonia at birth; scoliosis is progressive and may result in the loss of the ability to walk in one's 20's or 30's. Other common features include a "marfanoid habitus" characterized by long, slender fingers; unusually long limbs; and a sunken chest or protruding chest. *[https://rarediseases.info.nih.gov/diseases/2084/ehlers-danlos-syndrome-arthrochalasia-type Arthrochalasia Type] - presents with congenital hip dislocation and generalized joint hypermobility; may also have skin hyperextensibility, tissue fragility, kyphoscoliosis, and muscle hypotonia. *[https://rarediseases.info.nih.gov/diseases/2089/ehlers-danlos-syndrome-dermatosparaxis-type Dermatosparaxis Type] - presents with severe skin fragility and substantial [[bruising]]. *Other Types - [https://www.ehlers-danlos.com/eds-types/#BCS Brittle Cornea Syndrome (BCS)]; [https://www.ehlers-danlos.com/eds-types/#spEDS Spondylodysplastic EDS (spEDS)],[https://www.ehlers-danlos.com/eds-types/#mcEDS Musculocontractural EDS (mcEDS)], [https://www.ehlers-danlos.com/eds-types/#mEDS Myopathic EDS (mEDS)], [https://www.ehlers-danlos.com/eds-types/#pEDS Periodontal EDS (pEDS)] - this category groups the rarest genetic presentations sometimes only seen in one family.<ref name=":1" /><ref name=":0" /> == Prevalence == Ehlers-Danlos syndrome affects both males and females.<ref name=":0" /> 1 in 5,000 have some form of EDS worldwide.<ref name="Mao2002">{{Cite journal | title = The Ehlers-Danlos syndrome: on beyond collagens | date = 2001-05-01| url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC209288/|journal=Journal of Clinical Investigation|volume=107|issue=9 | pages = 1063β1069 | last = Mao | first = Jau-Ren | last2 = Bristow | first2 = James|pmid=11342567|issn=0021-9738}}</ref> Hypermobile EDS (hEDS) and classical forms of EDS (cEDS) are most common. Hypermobile may affect as many as 1 in 5,000 to 20,000 people, while the classical type probably occurs in 1 in 20,000 to 40,000 people. Other forms are rare, often with only a few cases or affected families in the world.<ref name="ghr">{{Cite web | url = https://ghr.nlm.nih.gov/condition/ehlers-danlos-syndrome#statistics | title = Ehlers-Danlos syndrome | last = | first = |website=Genetics Home Reference|language=en|access-date=2018-10-07}}</ref> == Risk factors == Ehlers-Danlos syndrome is a hereditary disease cause by a genetic mutation in one or more of the connective tissue genes, especially those involved in the metabolism of [[collagen]],<ref name=":2" /><ref name="Mao2002" /> an important protein found in muscle, skin, ligaments, tendons, cartilage, bones, blood vessels, and other body tissue.<ref name=":2" /> == Diagnosis == Diagnosis is made through physical examination which includes a test for hypermobility, such as the [[Beighton Scoring System]]<ref>{{Cite web | url = http://ehlers-danlos.com/assessing-joint-hypermobility/ | title = Assessing Joint Hypermobility|website=The Ehlers Danlos Society|access-date=2018-08-17|language=en-US}}</ref> or the [[Brighton criteria]] for EDS.<ref>{{Cite web | url = http://hypermobility.org/help-advice/hypermobility-syndromes/the-brighton-score/ | title = The Brighton Criteria for JHS | website = Hypermobility Syndromes Association|access-date=2018-08-17}}</ref> == Pathophysiology == EDS is a diverse group of inherited connective-tissue disorders. Joint hypermobility, skin fragility, and hyperextensibility characterize the disorders. Collagen defect has been identified in at least six types.<ref name=":2">{{Cite journal | last = | first = | date = Jan 11, 2018 | title = Ehlers-Danlos Syndrome: Background, Pathophysiology, Etiology| url = https://emedicine.medscape.com/article/1114004-overview#a5|url-access=registration|journal=Medscape|volume= | pages = |at=Pathophysiology|via=}}</ref> The vascular form is characterized by a decreased amount of type III collagen. It is [https://medlineplus.gov/ency/article/002049.htm autosomal dominant] (AD), one parent with a defective gene are needed to pass on this form of EDS and is caused by mutations in COL3A1. This results in increased fragility of connective tissue with arterial, intestinal, and uterine ruptures and premature death.<ref>{{Cite web | url = https://reference.medscape.com/medline/abstract/23489429 | title = A new COL3A1 mutation in Ehlers-Danlos syndrome type IV. | last = Eder | first = J | last2 = Laccone | first2 = F | date = |website=reference.medscape.com| publisher = Medscape|url-access=registration|issn=| archive-url = | archive-date = |url-status = | access-date=2018-10-06 | last3 = Rohrbach | first3 = M | last4 = Guinta | first4 = C | last5 = Aumayr | first5 = K | last6 = Reichel | first6 = C | last7 = Trautinger | first7 = F}}</ref> In EDS types I and II, cEDS and clEDS, causative mutations may involved the ''COL5A1, COL5A2,'' and ''tenascin-X'' genes and are implied to be in the ''COL1A2'' gene. "Although half of the mutations that cause Ehlers-Danlos syndrome types I and II are likely to affect the ''COL5A1'' gene, a significant portion of the mutations result in low levels of mRNA from the mutant allele as a consequence of nonsense-mediated mRNA decay."<ref name=":2" /> <ref>{{Cite web | url = https://reference.medscape.com/medline/abstract/10796876 | title = Null alleles of the COL5A1 gene of type V collagen are a cause of the classical forms of Ehlers-Danlos syndrome (types I and II). | last = Schwarze | first = U | last2 = Atkinson | first2 = M | date = |website=reference.medscape.com| publisher = Medscape|url-access=registration|issn=| archive-url = | archive-date = |url-status = | access-date=2018-10-06 | last3 = Hoffman | first3 = GG | last4 = Greenspan | first4 = DS | last5 = Byers | first5 = PH}}</ref> Kyphoscoliotic (type VI) is characterized by generalized joint laxity, skin fragility, and severe muscle hypotonia at birth. It is [https://medlineplus.gov/ency/article/002052.htm autosomal recessive] (AR), both parents with defective genes are needed to pass on this form of EDS. More than 20 mutations are identified in the LH1 gene that contributes to LH deficiency and clinical EDS type VI.<ref name=":2" /><ref>{{Cite web | url = https://reference.medscape.com/medline/abstract/11001813 | title = Mutations in the lysyl hydroxylase 1 gene that result in enzyme deficiency and the clinical phenotype of Ehlers-Danlos syndrome type VI. | last = Yeowell | first = HN | last2 = Walker | first2 = LC | date = |website=reference.medscape.com| publisher = Medscape|url-access=registration|issn=1096-7192| archive-url = | archive-date = |url-status = | access-date=2018-10-06}}</ref> [[Impaired wound healing]] is a typical feature of EDS.<ref name=":2" /> Pediatric patients have deficiencies in three genes of glutathione S-transferase family (''GSTM1, GSTT1, GSTP1'').<ref name=":2" /><ref>{{Cite web | url = https://reference.medscape.com/medline/abstract/18683505 | title = Polymorphism of detoxification genes and cell resistance to mutagens in patients with Ehlers-Danlos syndrome. | last = Kuz'mina | first = NS | last2 = Shipaeva | first2 = EV | date = |website=reference.medscape.com| publisher = Medscape|url-access=registration|issn=0007-4888| archive-url = | archive-date = |url-status = | access-date=2018-10-06 | last3 = Semyachkina | first3 = AN | last4 = Vasil'eva | first4 = IM | last5 = Kovalenko | first5 = LP | last6 = Durnev | first6 = LP | last7 = Zasukhina | first7 = GD}}</ref> Reduced activity of beta4GalT-7 is associated with the progeriform (causing children to age rapidly) EDS.<ref name=":2" /> "Biallelic mutations in ''FKBP14'' may result in a recessive form of Ehlers-Danlos syndrome with progressive kyphoscoliosis, myopathy, hearing loss, and, possibly, an increased risk for vascular complications."<ref name=":2" /><ref>{{Cite web | url = https://reference.medscape.com/medline/abstract/24677762 | title = FKBP14-related Ehlers-Danlos syndrome: expansion of the phenotype to include vascular complications. | last = Murray | first = ML | last2 = Yang | first2 = M | date = |website=reference.medscape.com| publisher = Medscape|url-access=registration|issn=| archive-url = | archive-date = |url-status = | access-date=2018-10-06 | last3 = Frauth | first3 = C | last4 = Byers | first4 = PH}}</ref> An ''[https://www.ehlers-danlos.com/eds-types/#chart EDS Types Chart]''<ref>{{Cite news |url =https://www.ehlers-danlos.com/eds-types/#chart | title = The Types of EDS | last = | first = | date = |work=The Ehlers Danlos Society|access-date=2018-10-06| archive-url = | archive-date = |url-status = | at=EDS Types Chart|language=en-US}}</ref> with AD/AR inheritance pattern (IP), genetic basis, and protein involved are provided by [https://www.ehlers-danlos.com/ The Ehlers Danlos Society]. == Systems affected by EDS == Systems affected by EDS include: * [[anxiety]] disorders and [[depression]] * bladder * bleeding * [[brain]] and spine * circulatory system, [[Cardiovascular system|cardiovascular]] * dental, oral, and voice problems * [[Digestive problems|digestive disorders]] * diverticulitis * heart and valve leakage * hernia * joint, musculoskeletal * ocular * reproductive * skin * subluxations and dislocations<ref>{{Cite web | url = https://www.ehlers-danlos.org/what-is-eds/information-on-eds/mental-health/ | title = Mental health β The Ehlers-Danlos Support UK | website = ehlers-danlos.org|language=en|access-date=2018-10-06}}</ref><ref>{{Cite web | url = https://www.ehlers-danlos.org/what-is-eds/information-on-eds/brain-and-spine/ | title = Brain and spine β The Ehlers-Danlos Support UK | website = ehlers-danlos.org|language=en|access-date=2018-10-07}}</ref><ref>{{Cite web | url = https://www.ehlers-danlos.org/what-is-eds/information-on-eds/dental-oral-and-voice-problems/ | title = Dental, oral and voice problems β The Ehlers-Danlos Support UK | website = ehlers-danlos.org|language=en|access-date=2018-10-07}}</ref><ref>{{Cite web | url = https://www.ehlers-danlos.org/what-is-eds/information-on-eds/digestive-disorders/ | title = Digestive disorders β The Ehlers-Danlos Support UK | website = ehlers-danlos.org|language=en|access-date=2018-10-07}}</ref><ref>{{Cite web | url = https://www.chronicpainpartners.com/ehlers-danlos-syndrome-common-associated-health-problems/ | title = Ehlers-Danlos Syndrome Commonly Associated Health Problems {{!}} EDSAwareness.com | website = chronicpainpartners.com|language=en|access-date=2018-10-06}}</ref><ref>{{Cite web | url = https://www.ehlers-danlos.org/what-is-eds/information-on-eds/joint-problems/ | title = Joint problems β The Ehlers-Danlos Support UK | website = ehlers-danlos.org|language=en|access-date=2018-10-07}}</ref><ref>{{Cite news |url =https://totaleyecare.com/ocular-complications-ehlers-danlos-syndrome/ | title = Ocular Complications of Ehlers Danlos Syndrome|work=Total Eye Care|access-date=2018-10-06|language=en-US}}</ref><ref>{{Cite news |url =https://www.msdmanuals.com/home/children-s-health-issues/connective-tissue-disorders-in-children/ehlers-danlos-syndrome | title = Ehlers-Danlos Syndrome - Children's Health Issues|work=MSD Manual Consumer Version|access-date=2018-10-07|language=en}}</ref><ref>{{Cite web | url = https://www.ehlers-danlos.org/what-is-eds/information-on-eds/postural-tachycardia-syndrome-pots/ | title = Postural tachycardia syndrome (PoTS)|website=The Ehlers-Danlos Support UK|language=en|access-date=2018-10-07}}</ref><ref>{{Cite news |url =https://www.healthline.com/health/erectile-dysfunction | title = Erectile Dysfunction (ED): Causes, Treatment, and More|work=Healthline|access-date=2018-10-07|language=en}}</ref><ref name="Hurst2012">{{Cite journal | last = Hurst | first = B.S. | last2 = Lang | first2 = M.B. | last3 = Kullstam | first3 = S.M. | last4 = Usadi | first4 = R.S. | last5 = Matthews | first5 = M.L. | last6 = Marshburn | first6 = P.B.| date = 2012 | title = Reproductive challenges in women with Ehlers-Danlos syndrome: survey results from over 1350 respondents from the Ehlers-Danlos National Foundation | url =https://www.fertstert.org/article/S0015-0282(12)01145-4/fulltext|journal=Fertility and Sterility|language=English|volume=98|issue=3 | pages = S112|doi=10.1016/j.fertnstert.2012.07.411|issn=0015-0282|via=}}</ref><ref>{{Cite web | url = https://www.ehlers-danlos.org/what-is-eds/information-on-eds/skin/ | title = Skin|website=The Ehlers-Danlos Support UK|language=en|access-date=2018-10-07}}</ref><ref>{{Cite news |url =https://www.ehlers-danlos.com/dislocation-subluxation-management/ | title = Dislocation/Subluxation Management|work=The Ehlers Danlos Society|access-date=2018-10-07|language=en-US}}</ref> ==Comorbidities & complications == ===ME/CFS === A 1999 case series by Dr. [[Peter Rowe]] of adolescents referred to his chronic fatigue syndrome clinic found 12 patients who also met the criteria for Ehlers-Danlos Syndrome and had orthostatic intolerance (postural orthostatic tachycardia or neurally-mediated hypotension). He concluded that βAmong patients with CFS and orthostatic intolerance, a subset also has EDS.β<ref name=":5">{{Cite journal | last = Rowe | first = Peter C. | last2 = Barron | first2 = Diana F. | last3 = Calkins | first3 = Hugh | last4 = Maumenee | first4 = Irene H. | last5 = Tong | first5 = Patrick Y. | last6 = Geraghty | first6 = Michael T. | date = 1999-10-01 | title = Orthostatic intolerance and chronic fatigue syndrome associated with Ehlers-Danlos syndrome | url =http://www.sciencedirect.com/science/article/pii/S0022347699701733|journal=The Journal of Pediatrics|volume=135|issue=4 | pages = 494β499|doi=10.1016/S0022-3476(99)70173-3|issn=0022-3476}}</ref> He also found joint hypermobility (Beighton score > 4) in 60% of pediatric ME/CFS patients viruses 24% of healthy controls.<ref name="Barron2002">{{Cite journal | last = Barron | first = Diana F. | last2 = Cohen | first2 = Bernard A. | last3 = Geraghty | first3 = Michael T. | last4 = Violand | first4 = Rick | last5 = Rowe | first5 = Peter C. | date = 2002-09-01 | title = Joint hypermobility is more common in children with chronic fatigue syndrome than in healthy controls |url =http://www.sciencedirect.com/science/article/pii/S0022347602001105|journal=The Journal of Pediatrics|volume=141|issue=3 | pages = 421β425|doi=10.1067/mpd.2002.127496|issn=0022-3476}}</ref> A 2022 study by Rowe found that hypermobility did not show any association with other clinical characteristics of ME/CFS, despite it being a risk factor for the development of ME/CFS.<ref>{{Cite journal | title = The Presentation of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Is Not Influenced by the Presence or Absence of Joint Hypermobility | date = Jan 2022| url = https://pubmed.ncbi.nlm.nih.gov/34537220/|journal=The Journal of Pediatrics|volume=240 | pages = 186β191.e2 | last = Vogel | first = Sarah K. | last2 = Primavera | first2 = Isabelle R. | last3 = Marden | first3 = Colleen L. | last4 = Jasion | first4 = Samantha E. | last5 = Cranston | first5 = Erica M. | last6 = Flaherty | first6 = Marissa A.K. | last7 = Violand | first7 = Richard L. | last8 = Rowe | first8 = Peter C.|doi=10.1016/j.jpeds.2021.09.014|pmid=34537220|issn=1097-6833}}</ref> A Swedish study of 234 ME/CFS patients meeting theΒ [[Canadian Consensus Criteria]] found that 49% of patients had hypermobility and 20% met the criteria for hEDS.<ref>{{Cite web | url = https://osf.io/qwn5h/|website=Center for Open Science|access-date=2019-12-03 | title = Bragee Bertilson et al. - ME CFS and Intracranial Hypertension | date = Nov 27, 2019 | last = | first = | authorlink = |archive-url=|archive-date=|url-status=}}</ref> === Other === * [[Dysautonomia]] * [[Mast cell activation syndrome]] * [[Postural orthostatic tachycardia syndrome]]<ref>{{Cite web | url = https://www.inspire.com/groups/ehlers-danlos-syndromes-and-related-disorders/discussion/the-ehlers-danlos-society-is-forming-a-comorbid-condition-coalition/ | title = The Ehlers-Danlos Society is forming a Comorbid Condition Coalition! - Inspire | last = | first = | date = Nov 8, 2017 | website = inspire.com| archive-url = | archive-date = |url-status = | access-date=2018-10-07}}</ref><ref>{{Cite news |url =http://www.thepainrelieffoundation.com/craniocervical-instability/ | title = What is Craniocervical Instability? - The Pain Relief Foundation|work=The Pain Relief Foundation|access-date=2018-10-07|language=en-US}}</ref><ref>{{Cite news |url =https://www.ehlers-danlos.com/2017-eds-classification-non-experts/neurological-spinal-manifestations-ehlers-danlos-syndromes/ | title = Neurological and Spinal Manifestations of the Ehlers-Danlos Syndromes (for Non-experts) {{!}} The Ehlers Danlos Society|work=The Ehlers Danlos Society|access-date=2018-10-07|language=en-US}}</ref> * [[Chiari malformation]]<ref name=":4">{{Cite journal | last = Henderson | first = Fraser C. | last2 = Austin | first2 = Claudiu | last3 = Benzel | first3 = Edward | last4 = Bolognese | first4 = Paolo | last5 = Ellenbogen | first5 = Richard | last6 = Francomano | first6 = Clair A. | last7 = Ireton | first7 = Candace | last8 = Klinge | first8 = Petra | last9 = Koby | first9 = Myles | date = 2017-02-21 | title = Neurological and spinal manifestations of the Ehlers-Danlos syndromes |url =https://onlinelibrary.wiley.com/doi/full/10.1002/ajmg.c.31549|journal=American Journal of Medical Genetics Part C: Seminars in Medical Genetics|language=en|volume=175|issue=1 | pages = 195β211|doi=10.1002/ajmg.c.31549|issn=1552-4868}}</ref> * [[Syringomyelia]]<ref name=":4" /> * [[Craniocervical instability]]<ref name=":4" /> * [[Atlantoaxial instability]]<ref name=":4" /> * [[Intracranial hypertension]]<ref name=":4" /> * [[Kyphosis]]<ref name=":4" /> and [[Scoliosis]]<ref name=":4" /> * [[Tethered cord syndrome]]<ref name=":4" /> * [[Dystonia]]<ref name=":4" /> * [[Tarlov cyst]]<ref name=":4" /> * [[prolapsed mitral valve|Mitral valve prolapse]] == Treatment == '''Medications''' There is no cure for EDS and treatments arenβt limited to over-the-counter pain relievers such as acetaminophen (Tylenol and others) ibuprofen (Advil, Motrin IB, others), and naproxen sodium (Aleve). Prescription medications are used for acute injuries and chronic pain. Blood pressure medications are sometimes used to keep pressure low to relieve stress on vessels.<ref name=":3">{{Cite web | url = https://www.mayoclinic.org/diseases-conditions/ehlers-danlos-syndrome/diagnosis-treatment/drc-20362149 | title = Ehlers-Danlos syndrome - Diagnosis and treatment - Mayo Clinic|website=Mayo Clinic|language=en|access-date=2018-10-07}}</ref> '''Physical therapy''' Because dislocations occur in EDS, exercise to strengthen the muscles and stabilize joints are the primary treatment. Braces help prevent joint dislocations.<ref name=":3" /> However when patients with severe CFS/ME physical therapy must be done incrementally . '''Surgical and other procedures''' Surgery may be recommended to repair joints damaged by dislocations but connective tissue may not heal properly. Ruptured blood vessels or organs for patients with VEDS may also be necessary.<ref name=":3" /> == See also == * [[Collagen]] *[[Joint hypermobility|Joint hypermobility and hypermobility syndromes]] ==Learn more== * [http://www.rcgp.org.uk/clinical-and-research/resources/toolkits/ehlers-danlos-syndromes-toolkit.aspx Ehlers-Danlos Syndrome Toolkit]<ref>{{Cite web | url = http://www.rcgp.org.uk/clinical-and-research/resources/toolkits/ehlers-danlos-syndromes-toolkit.aspx | title = Ehlers Danlos Syndromes Toolkit | last = | first = | date = | website = rcgp.org.uk| publisher = Royal College of General Practitioners|language=en| archive-url = | archive-date = |url-status = | access-date=2018-10-29}}</ref> * [https://www.ehlers-danlos.org/information/pregnancy-birth-feeding-and-hypermobile-ehlers-danlos-syndrome-hypermobility-spectrum-disorders/ Pregnancy, birth, feeding and hypermobile Ehlers-Danlos syndrome / hypermobility spectrum disorders]<ref>{{Cite web | url = https://www.ehlers-danlos.org/information/pregnancy-birth-feeding-and-hypermobile-ehlers-danlos-syndrome-hypermobility-spectrum-disorders/ | title = Pregnancy, birth, feeding and hypermobile Ehlers-Danlos syndrome / hypermobility spectrum disorders β The Ehlers-Danlos Support UK | website = ehlers-danlos.org|language=en|access-date=2018-10-07}}</ref> *2016, [http://www.healthrising.org/blog/2016/07/01/chronic-fatigue-fibromyalgia-ehlers-danlos-syndrome-diagnosis/ Another Piece of the Puzzle: An ME/CFS/FM Patient Gets an Ehlers Danlos Syndrome Diagnosis]<ref>{{Cite news |url =http://www.healthrising.org/blog/2016/07/01/chronic-fatigue-fibromyalgia-ehlers-danlos-syndrome-diagnosis/ | title = Another Piece of the Puzzle: An ME/CFS/FM Patient Gets an Ehlers Danlos Syndrome Diagnosis - Health Rising | last = Burns | first = Darden | date = 2016-07-01|work=Health Rising|access-date=2018-08-17| archive-url = | archive-date = |url-status = | language=en-US}}</ref> *[https://www.lecturio.com/magazine/wall_structure_of_arteries_and_veins/ Blood Vessels β Wall Structure of Arteries and Veins] == References== {{reflist}} [[Category:Diagnoses]] [[Category:Potential comorbidities]] [[Category:Genetic diseases and disorders]]
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