Certain Complications More Common in Hospitalized EDS Patients

Hospitalized patients with Ehlers-Danlos syndrome (EDS) experience more gastrointestinal (GI), cardiovascular, nervous, and allergic conditions than those without EDS, a recent study has found.

The findings suggest physicians should consider the possibility of EDS and exercise appropriate precautions when examining patients in whom these conditions have no other apparent explanation.

The study, “Prevalence of gastrointestinal, cardiovascular, autonomic, and allergic manifestations in hospitalized patients with Ehlers-Danlos syndrome: a case-control study,” was published in the journal Rheumatology.

Observations made in individual cases or in a small number of patients followed at specialist clinics have suggested an association between EDS and complications involving the GI, cardiovascular, immune, and autonomic (involuntary) nervous systems. However, the true frequency and nature of these conditions among those with EDS remains unknown.

A team of researchers from across the U.S. analyzed patient records from the 2016 National Inpatient Sample to see if EDS could be associated with a higher prevalence of these conditions and to establish whether outcomes for hospitalized EDS patients might differ from those of non-EDS patients (controls).

From the 6,021 records they analyzed, 2,007 belonged to EDS patients.

Analyses revealed that GI conditions were more common in EDS patients than controls (44% vs. 18%). Irritable bowel syndrome, gastroparesis (a partial paralysis of the stomach preventing it from emptying properly), and celiac disease all were found to be strongly associated with EDS.

Risk for GI complications rose with age and appeared more frequently in women than in men.

Autonomic dysfunction also was more frequent among EDS patients than controls (20% vs. 6%). Some of these conditions included postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope, and orthostatic hypotension, all of which cause blood pressure to drop and sometimes result in unconsciousness.

Hospitalized people with EDS were nearly four times more likely to have food allergies and about six times more likely to experience cardiovascular complications, including valve disorders, aneurysms, and dysrhythmias (heart rhythm disorders).

The prevalence of these conditions did not appear to be influenced by age, race, or smoking status.

Although this study found EDS patients were 76% more likely to have longer-than-average hospital stays, meaning those lasting more than four days, the researchers observed little difference in mortality.

The team that did the study expects its findings will encourage physicians to consider EDS when evaluating patients experiencing these conditions for no apparent reason.

“This study and its novel findings will enable physicians in hospital and outpatient settings to have an increased awareness for the incidence of GI, cardiovascular, autonomic, and allergic manifestations in patients with EDS,” they concluded.