Overview
Ehlers-Danlos syndrome is a group of inherited disorders that affect your connective tissues — primarily your skin, joints and blood vessel walls. Connective tissue is a complex mixture of proteins and other substances that provide strength and elasticity to the underlying structures in your body.
People who have Ehlers-Danlos syndrome usually have overly flexible joints and stretchy, fragile skin. This can become a problem if you have a wound that requires stitches, because the skin often isn't strong enough to hold them.
A more severe form of the disorder, called vascular Ehlers-Danlos syndrome, can cause the walls of your blood vessels, intestines or uterus to rupture. Because vascular Ehlers-Danlos syndrome can have serious potential complications in pregnancy, you may want to talk to a genetic counselor before starting a family.
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Symptoms
There are many different types of Ehlers-Danlos syndrome, but the most common signs and symptoms include:
- Overly flexible joints. Because the connective tissue that holds joints together is looser, your joints can move far past the normal range of motion. Joint pain and dislocations are common.
- Stretchy skin. Weakened connective tissue allows your skin to stretch much more than usual. You may be able to pull a pinch of skin up away from your flesh, but it will snap right back into place when you let go. Your skin might also feel exceptionally soft and velvety.
- Fragile skin. Damaged skin often doesn't heal well. For example, the stitches used to close a wound often will tear out and leave a gaping scar. These scars may look thin and crinkly.
Symptom severity can vary from person to person and depends on the specific type of Ehlers-Danlos syndrome that you have. The most common type is called hypermobile Ehlers-Danlos syndrome.
Vascular Ehlers-Danlos syndrome
People who have vascular Ehlers-Danlos syndrome often share distinctive facial features of a thin nose, thin upper lip, small earlobes and prominent eyes. They also have thin, translucent skin that bruises very easily. In fair-skinned people, the underlying blood vessels are very visible through the skin.
Vascular Ehlers-Danlos syndrome can weaken your heart's largest artery (aorta), as well as the arteries to other regions of your body. A rupture of any of these larger blood vessels can be fatal. The vascular type can also weaken the walls of the uterus or large intestines — which also may rupture.
Causes
Different types of Ehlers-Danlos syndrome are associated with a variety of genetic causes, some of which are inherited and passed on from parent to child. If you have the most common form, hypermobile Ehlers-Danlos syndrome, there's a 50% chance that you'll pass on the gene to each of your children.
Complications
Complications depend on the types of signs and symptoms you have. For example, overly flexible joints can result in joint dislocations and early-onset arthritis. Fragile skin may develop prominent scarring.
People who have vascular Ehlers-Danlos syndrome are at risk of often fatal ruptures of major blood vessels. Some organs, such as the uterus and intestines, also may rupture. Pregnancy can increase the risk of a rupture in the uterus.
Prevention
If you have a personal or family history of Ehlers-Danlos syndrome and you're thinking about starting a family, you may benefit from talking to a genetic counselor — a health care professional trained to assess the risk of inherited disorders. Genetic counseling can help you understand the inheritance pattern of the type of Ehlers-Danlos syndrome that affects you and the risks it poses for your children.
By Mayo Clinic Staff
Ehlers-Danlos syndrome care at Mayo Clinic
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Aug. 25, 2022
- Ehlers-Danlos syndromes. Genetic and Rare Diseases Information Center (GARD). https://rarediseases.info.nih.gov/diseases/6322/ehlers-danlos-syndromes. Accessed Aug. 12, 2020.
- Ferri FF. Ehlers-Danlos syndrome. In: Ferri's Clinical Advisor 2021. Elsevier; 2021. https://www.clinicalkey.com. Accessed Aug. 12, 2020.
- Pauker SP, et al. Clinical manifestations and diagnosis of Ehlers-Danlos syndromes. https://www.uptodate.com/contents/search. Accessed Aug. 12, 2020.
- Kliegman RM, et al. Ehlers-Danlos syndrome. In: Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Aug. 12, 2020.
- AskMayoExpert. Ehlers-Danlos syndromes. Mayo Clinic; 2019.
- Pauker SP, et al. Overview of management of Ehlers-Danlos syndromes. https://www.uptodate.com/contents/search. Accessed Aug. 12, 2020.
- An educator's guide: Meeting the needs of the Ehlers-Danlos child. Ehlers-Danlos National Foundation. https://ehlers-danlos.com/resource-guides. Accessed Aug. 12, 2020.
- Deyle DR (expert opinion). Mayo Clinic. Sept. 22, 2020.
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