Case Report

Ehlers Danlos Syndrome: An Unusual Presentation You Need to Know about

Table 1

Overview of Ehlers-Danlos syndromes (adapted from De Paepe and Malfait [2].)

EDS subtypes (former type)InheritanceMajor symptomsGenes

Classic (I/II)ADSkin hyperextensibility
Widened atrophic scars
COL5A1/COL5A2  
COL1A1  
ARJoint hypermobility, muscle weakness, and distal contracturesTNX-B
Hypermobility (III)ADGeneralized hypermobility and subtle skin findings?
Vascular (IV)ADArterial and hollow organ rupture at a young ageCOL3A1
Vascular-likeADFeatures of both classic and vascular typesCOL1A1
Cardiac-valvularARIn childhood: mild skin, joint hypermobility, hypotonia, and osteopenia. In adulthood: severe valve diseaseCOL1A2
EDS with periventricular heterotopiaXLRNodular brain heterotopia and classic EDS symptomsFLNA  
ARFGEF2
Kyphoscoliotic (VIa)AREarly progressive kyphoscoliosisPLOD1
Musculocontractural (VIb)ARCraniofacial abnormalities, joint contracture, hypotonia, and GI/GU problemsCHST14
Arthrochalasis (VIIa/VIIb)ADCongenital bilateral hip dislocationCOL1A1/COL1A2
Dermatosparaxis (VIIc)ARSagging skin, delayed fontanels closure, eye lid edema, and short stature and fingers. ADAMTS2
Periodontal (VIII)ADSevere early-onset periodontitis12p13
Occipital horn syndrome (IX)XLRLoose skin, delayed intelligence, hernias, twisted blood vessels, dysautonomia, and hair abnormalities.ATP7A
SpondylocheirodysplasticARShort stature and mild skeletal dysplasiaSLC39A13
EDS-SticklerARPierre-Robin sequence and eye abnormalities.PLOD3
EDS-OIADBone fragility and classic EDS symptomsCOL1A1/COL1A2
Brittle cornea syndromeAROcular fragility and keratoconus ZNF469  
PRDM5
Progeroid EDSARWrinkled face, curly fine hair, and periodontitisB4GALT7

AR: autosomal recessive; AD: autosomal dominant; XLR: X-linked recessive; OI: osteogenesis imperfecta; GI: gastrointestinal; GU: genitourinary; and ?: unknown.