Cited by 230Cardiovascular Syncope and Autonomic DisordersFibromyalgia and Chronic Fatigue Syndrome ResearchConnective tissue disorders research

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Orthostatic intolerance and chronic fatigue syndrome associated with Ehlers-Danlos syndrome

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Rowe, Peter C., Barron, Diana F., Calkins, Hugh, Maumenee, Irene H., Tong, Patrick Y., Geraghty, Michael T.·1999·The Journal of Pediatrics

DOI 10.1016/s0022-3476(99)70173-3

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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.

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Self-citation

Authors: Rowe, P. C., Barron, D. F., Calkins, H., Maumenee, I. H., Tong, P. Y., & Geraghty, M. T.
Affiliations: Johns Hopkins University (US)
ORCID: Rowe, Peter C.
Maumenee, Irene H.
Geraghty, Michael T.
Venue: The Journal of Pediatrics
Publisher: Elsevier BV
Published: 1999-10
Volume: 135
Issue: 4
Pages: 494-499
ISSN: 0022-3476 (ISSN-L)
DOI: 10.1016/s0022-3476(99)70173-3
OpenAlex: W2033921066
Cited by: 230
References: 49
Citations by year: 2026: 14 · 2025: 17 · 2024: 17 · 2023: 8 · 2022: 17 · 2021: 10 · 2020: 8 · 2019: 6 · 2018: 12 · 2017: 15 · 2016: 8 · 2015: 5 · 2014: 11 · 2013: 12 · 2012: 6
FWCI: 2.81
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by-nc-nd/4.0/ (vor, 2591 d)
Locations: The Journal of Pediatrics (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r01ai039500-03)
National Institute of Allergy and Infectious Diseases (AI 39500)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
Keywords: Ehlers-Danlos syndrome, chronic fatigue syndrome, orthostatic intolerance, postural orthostatic tachycardia syndrome, hypermobile Ehlers-Danlos syndrome, connective tissue abnormalities, venous pooling, adolescents
MeSH terms: Adolescent, Adult, Blood Pressure, Child, Ehlers-Danlos Syndrome, Female, Heart Rate, Humans, Hypotension, Orthostatic, Male, Fatigue Syndrome, Chronic

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Orthostatic intolerance and chronic fatigue syndrome associated with Ehlers-Danlos syndrome

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