Abstract
Objective: To report chronic fatigue syndrome (CFS) associated with both Ehlers-Danlos syndrome
(EDS) and orthostatic intolerance. Study design: Case series of adolescents referred to a tertiary clinic for the evaluation of CFS.
All subjects had 2-dimensional echocardiography, tests of orthostatic tolerance, and
examinations by both a geneticist and an ophthalmologist. Results: Twelve patients (11 female), median age 15.5 years, met diagnostic criteria for CFS
and EDS, and all had either postural tachycardia or neurally mediated hypotension
in response to orthostatic stress. Six had classical-type EDS and 6 had hypermobile-type
EDS. Conclusions: Among patients with CFS and orthostatic intolerance, a subset also has EDS. We propose
that the occurrence of these syndromes together can be attributed to the abnormal
connective tissue in dependent blood vessels of those with EDS, which permits veins
to distend excessively in response to ordinary hydrostatic pressures. This in turn
leads to increased venous pooling and its hemodynamic and symptomatic consequences.
These observations suggest that a careful search for hypermobility and connective
tissue abnormalities should be part of the evaluation of patients with CFS and orthostatic
intolerance syndromes. (J Pediatr 1999;135:494-9)
Abbreviations:
CFS (Chronic fatigue syndrome), EDS (Ehlers-Danlos syndrome)To read this article in full you will need to make a payment
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Article Info
Publication History
Accepted:
April 22,
1999
Received in revised form:
January 21,
1999
Received:
October 15,
1998
Footnotes
☆Supported in part by generous donations from the Boies family, Jacqueline Wolfe, and the friends of Polly Kelly and by grants from the Sunshine Foundation and the National Institutes of Health (Dr Rowe, AI 39500).
☆☆Reprint requests: Peter C. Rowe, MD, Brady 212, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287.
★0022-3476/99/$8.00 + 0 9/21/99543
Identification
Copyright
© 1999 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
