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J Pediatr. 1999 Oct;135(4):4949.
Orthostatic intolerance and chronic fatigue syndrome associated
with EhlersDanlos syndrome.
Rowe PC1, Barron DF, Calkins H, Maumenee IH, Tong PY, Geraghty MT.
Author information
Abstract
OBJECTIVE: To report chronic fatigue syndrome (CFS) associated with both EhlersDanlos
syndrome (EDS) and orthostatic intolerance.
STUDY DESIGN: Case series of adolescents referred to a tertiary clinic for the evaluation of CFS.
All subjects had 2dimensional 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 classicaltype EDS and 6 had hypermobiletype 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.
PMID: 10518084
[Indexed for MEDLINE]
Publication types, MeSH terms, Grant support
Publication types
Research Support, NonU.S. Gov't
Research Support, U.S. Gov't, P.H.S.
MeSH terms
Adolescent
Adult
Blood Pressure
Child
https://www.ncbi.nlm.nih.gov/pubmed/10518084 1/2
8/8/2017 Orthostatic intolerance and chronic fatigue syndrome associated with Ehlers-Danlos syndrome. - PubMed - NCBI
EhlersDanlos Syndrome/complications*
EhlersDanlos Syndrome/diagnosis
Fatigue Syndrome, Chronic/complications*
Fatigue Syndrome, Chronic/diagnosis
Female
Heart Rate
Humans
Hypotension, Orthostatic/complications*
Hypotension, Orthostatic/diagnosis
Male
Grant support
AI 39500/AI/NIAID NIH HHS/United States
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https://www.ncbi.nlm.nih.gov/pubmed/10518084 2/2