Benign joint hypermobility minimally impacts autonomic abnormalities in pediatric subjects with chronic functional pain disorders
Abstract
Objective To determine if children with benign joint hypermobility (BJH) syndrome and chronic functional pain disorders have more autonomic dysfunction.Study design Retrospective chart review study of pediatric patients seen in the pediatric neurogastroenterology and autonomic clinic who underwent autonomic testing and had either a Beighton score of ≥6 and met Brighton criteria for BJH (with BJH) or a score of ≤2 (no BJH).Results Twenty-one female subjects (10 without BJH) met inclusion criteria; 64% of BJH had diagnosis confirmed by genetics consultation. We evaluated for postural tachycardia syndrome, syncope, orthostatic intolerance, and orthostatic hypotension. None of these diagnoses, as well as baseline heart rate, peak heart rate in first 10 minutes of head up tilt (P = .35 and P = .61, respectively), and sudomotor index (suggestive of autonomic neuropathy) (P = .58), showed differences between the groups. Age of onset of symptoms was also similar (P = .61) (BJH vs without BJH: median [range]:15.6 years [12.9-17.5] vs 15.4 years [11.1-18.2]). There was no difference between groups in complaints of migraine, chronic nausea, chronic fatigue, lightheadedness, dizziness, fainting >3 times/lifetime, delayed onset of sleep, irritable bowel syndrome, dyspepsia, abdominal migraine, functional abdominal pain, constipation, or fibromyalgia.Conclusions Children with chronic functional pain disorders and BJH have autonomic testing findings and comorbid features compared with a similar cohort of subjects without BJH, suggesting that BJH is not the driver of the autonomic and comorbid disorders.
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There is no apparent difference in prevalence between the incidence of joint hypermobility in POTS patients and patients with other underlying chronic functional conditions.
“In fact, there is no apparent difference in prevalence between the incidence of joint hypermobility in POTS patients and patients with other underlying chronic functional conditions.”
From Postural Orthostatic Tachycardia Syndrome (2019) · cites this paper as [71]
Joint hypermobility may not be pathophysiologically important for the development of orthostatic intolerance in POTS patients; rather it may be another comorbid condition that occurs in patients with chronic functional disorders.
“This suggests that joint hypermobility may not be pathophysiologically important for the development of orthostatic intolerance in POTS patients; rather it may be another comorbid condition that occurs in patients with chronic functional disorders (71).”
From Postural Orthostatic Tachycardia Syndrome (2019) · cites this paper as [71]
In a retrospective review of children with chronic functional pain disorders (11 with joint hypermobility syndrome, 10 without), there were no differences in migraines or other comorbid disorders including orthostatic intolerance.
“In a retrospective review of pediatric patients with chronic functional pain disorders, 11 with JHS and 10 without, there were no di ff erences in migraines or other co-morbid disorders including orthostatic intolerance.”
From Postural tachycardia syndrome and other forms of orthostatic intolerance in Ehlers-Danlos syndrome (2018) · cites this paper as Chelimsky et al., 2016
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- Authors
- Chelimsky, G., Kovacic, K., Simpson, P., Nugent, M., Basel, D., Banda, J., & Chelimsky, T.
- Affiliations
- Medical College of Wisconsin (US)
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 2016-10
- Volume
- 177
- Pages
- 49-52
- ISSN
- 0022-3476 (ISSN-L)
- OpenAlex
- W2498071829
- Cited by
- 16
- References
- 25
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 4 · 2018: 2
- FWCI
- 2.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- autonomic dysfunction, autonomic neuropathy, postural orthostatic tachycardia syndrome, orthostatic intolerance, orthostatic hypotension, syncope, head-up tilt, heart rate, sudomotor function, pediatric patients, comorbidities, migraine, irritable bowel syndrome, fibromyalgia
- MeSH terms
- Adolescent, Autonomic Nervous System, Child, Female, Humans, Joint Instability, Retrospective Studies, Chronic Pain
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