Presentation
Present On Admission POA Help "Present On Admission" is defined as present at the time the order for inpatient admission occurs — conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery [icd10data.com]
(Presentation of the clinical and radiographic presentation of cranio-cervical hypermobility, cranial settling and Chiari malformation in the hereditary connective tissue disorders, including EDS.) [clinicaladvisor.com]
As we have seen with our cohort of 2617 patients, the hypermobility present in childhood can diminish or disappear in adulthood. It can also be replaced by retractions from infancy [ 7 ], causing diagnosis errors. [omicsonline.org]
Only 14 cases of spontaneous colonic perforation have been reported in the literature, but only two in children 1, 2 Skin and joint manifestations are less prominent than in other types of EDS, and type IV presents with complications such as arterial, [academic.oup.com]
Sponsored by www.bodysupportstore.com TOPIC: “Vascular Ehlers-Danlos Syndrome / EDS type IV” PRESENTER : Dr. Peter Byers About our speaker: Dr. [chronicpainpartners.com]
Entire Body System
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Lymphedema
[…] reflux, constipation, bloating), urological, sexual (dyspareunia), miscarriage, difficult childbirth, sleep disturbances, diffuse tonic or deficit crises, cysts and nodules in the skin or internal organs, pneumothorax, vascular complications (edema, lymphedema [omicsonline.org]
hereditary, type 1A FLT4 Lymphedema, hereditary, type IC GJC2 Lymphoproliferative syndrome type 2 CD27 Majeed syndrome LPIN2 Major histocompatibility comples 1 deficiency MR1 Mal de Meleda SLURP1 Mandibuloacral dysplasia with type B lipodystrophy ZMPSTE24 [centogene.com]
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Hypothermia
• Neurovegetative disorders (intolerance to vertical position, sweating, tachycardia, hypotension, hypothermia, chilliness, cold extremities, especially feet). • Hemorrhages (bruising, gingivorrhagia, epistaxis, metrorrhagia). • Hypersensitivity: Hearing [omicsonline.org]
Hematological
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Easy Bruising
The surgeons chose a total colectomy because recurrent perforation is frequent in patients treated with resection and diversion. 11 The association of ‘spontaneous’ colonic perforation, haemostatic disorders with tendency to easy bruise should raise a [academic.oup.com]
Possible diagnosis of EDS type VIII: Clinical features of EDS VIII such as hyperextensible joints, atrophic scarring, and easy bruising can often overlap with other forms of EDS. [uwcpdx.org]
Easy bruising is common. Joint hypermobility is the primary clinical manifestation. [nature.com]
Signs and Symptoms of Vascular EDS The signs and symptoms of vascular EDS vary by patient; however, easy bruising, even after sustaining only minor trauma, is a common finding. 2,3 Patients with this condition may have soft skin that appears thin and [raredr.com]
[…] from classical form Type V X-linked Similar to mild classical type X-linked recessive inheritance Unknown molecular defect Type X Joint hyperextensibility, mitral valve prolapse, easy bruising, poor wound healing, clotting disorder Clotting studies showed [en.wikibooks.org]
Skin
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Keratosis
[…] palmaris et plantaris Keratosis follicularis [Darier-White] Type 1 Excludes Ehlers-Danlos syndrome ( Q79.6 ) ICD-10-CM Diagnosis Code M35.7 Hypermobility syndrome 2016 2017 2018 2019 Billable/Specific Code Applicable To Familial ligamentous laxity Type [icd10data.com]
[…] follicularis spinulosa declavans, X-linked MBTPS2 Keratosis linearis with ichthyosis congenita and sclerosing keratoderma POMP Keratosis palmoplantaris striata type 1 DSG1 Keratosis palmoplantaris striata type 2 DSP Kindler syndrome FBLIM1 Kindler syndrome [centogene.com]
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Eruptions
The patient still had peculiar facies, a large fontanel, psychomotor developmental delay and late eruption of teeth. A second umbilical hernia surgery was performed. [ncbi.nlm.nih.gov]
Eyes
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Blurred Vision
• Vision problems: Visual fatigue with blurred vision and image splitting. • Respiratory blockages, shortness of breath on minimal exertion. • Presence of cognitive and behavioral disorders: memory, attention, concentration, orientation, hyperactivity [omicsonline.org]
Musculoskeletal
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Muscle Hypotonia
Major criteria are: Short stature (progressive in childhood); Muscle hypotonia (ranging from severe congenital, to mild later-onset); and Bowing of limbs. [ehlers-danlos.com]
Diagnosis requires congenital muscle hypotonia and congenital or early-onset kyphoscoliosis, plus either GJH or three minor criteria. Confirmatory testing is needed for a final diagnosis. Major criteria Congenital muscle hypotonia. [patient.info]
Immobility may have arisen from joint damage, deformity or muscle hypotonia. However, many of our patients had low bone mass even in their 20s, supporting an effect on bone mass that is either inherited or acting in the early years. [ard.bmj.com]
hypotonia Other features Ocular fragility Skin fragility Easy bruisability Dermal hyperextensibility Risk for arterial rupture Most have radiologically detectable osteopenia (decreased bone density), but pathological fractures are rare Intelligence is [en.wikibooks.org]
hypotonia at birth Progressive scoliosis present from birth Scleral fragility or rupture of ocular globe Tissue fragility (atrophic scarring); eary bruising Arterial rupture Marfan-like habitus Microcornea Osteopenia as defined radiologically Positive [physio-pedia.com]
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Arthralgia
Arthralgia is a predominant chief complaint that might lead to a diagnosis of HEDS patients. Similarly, arthralgia is also a major complaint in many rheumatological conditions (i.e. [nature.com]
[…] of skin, acrogeria( older appearance), cigar shaped scars,keloid formation) Mitral Prolapse and Aortic Regurgitation cannot be ruled out in EDS vascular type Corneal Displacement cannot be ruled out in Marfans Dural Ectasia cannot be ruled out in EDS Arthralgia [forums.studentdoctor.net]
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Severe Joint Laxity
This form of EDS is congenital, and is associated with severe muscle hypotonia, scleral fragility, placing the globe at an increased risk for rupture, and severe joint laxity in addition to the scoliosis. [morphopedics.wikidot.com]
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Thin Fingers
In retrospect, this child had several major criteria of EDS: 4 history of spontaneous colonic perforation, easy bruising, characteristic face, keloid on the chin and forehead, 3 and translucent dry skin with venous prominence at thoracic area, thin fingers [academic.oup.com]
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Torticollis
[…] malformations, deformations and chromosomal abnormalities Q79 ICD-10-CM Diagnosis Code Q79 Congenital malformations of musculoskeletal system, not elsewhere classified 2016 2017 2018 2019 Non-Billable/Non-Specific Code Type 2 Excludes congenital (sternomastoid) torticollis [icd10data.com]
Psychiatrical
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Behavior Disorder
• Presence of cognitive and behavioral disorders: memory, attention, concentration, orientation, hyperactivity, anxiety. • Other events may be associated. [omicsonline.org]
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Hysteria
This trend will continue into adulthood, leading to abusive diagnoses of depressive states, bipolar states and, of course, hypochondria, somatization, hysteria... [omicsonline.org]
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Fidgeting
This begins in childhood, with accusations of laziness, tendency to complain for nothing, insubordination and not staying still because of body perception disorders that force these kids to fidget constantly. [omicsonline.org]
Neurologic
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Hyperactivity
• Presence of cognitive and behavioral disorders: memory, attention, concentration, orientation, hyperactivity, anxiety. • Other events may be associated. [omicsonline.org]
Workup
Figure 1: Distribution of number of rheumatological diagnoses by workup status. NWU, no workup; LWU, limited workup; CWU, comprehensive workup. [nature.com]
[…] each elbow 10 (1 point each) forward flexion of trunk with palms on floor and knees fully extended (1 point) Imaging Radiographs look for joint dislocations/subluxations kyphoscoliosis Echocardiogram cardiac evaluation with echo is mandatory in the workup [orthobullets.com]
(October 2018 editor’s note: I used to have another pre-diagnostic medical workup page linked from The Coalition Against Pediatric Pain here too, but it seems to have been deleted, sorry!) [ohtwist.com]
Treatment
With regard to the lower limbs, a choice between conservative treatment vs. surgical treatment is an important step in the treatment process. [f1000research.com]
Given the rarity of these diseases, the treatments outlined in the abstracts are not always evidence based. The information in the abstracts isnot intended to replace existing local, regional or country specific recommendations and guidelines. [orpha.net]
Otherwise, there are also iatrogenic complications (anticoagulant treatments, poorly controlled surgical procedures, etc.). Among these iatrogenic effects, psychiatrization holds a very important place. [omicsonline.org]
This may account for the delay in getting a proper diagnosis and treatment, as studies have repeatedly shown the medical community is not as educated on — and therefore much more likely to misdiagnose and disregard — health issues that impact women. [health.harvard.edu]
Prognosis
The best treatment depends on the prognosis and current situation of the child. [f1000research.com]
The prognosis with this type is poor. Sudden death can occur after visceral perforation or after the rupture of a large vessel, most commonly an abdominal and splenic vessel. [emedicine.medscape.com]
Due to different clinical symptoms, natural history and prognosis, EDS type IV should be assessed separately within the group of EDS. [ojrd.biomedcentral.com]
Etiology
The initial chapters discuss surgical anatomy of hernias, incidence and etiology, diagnosis and anaesthesia. The following sections are each dedicated to a different type of hernia and its surgical management. [books.google.de]
They are organised into groups, and further divided into clinical, etiological or histopathological sub-types. [orpha.net]
[…] have cardiac abnormalities Mitral valve prolapse Aortic root dilation with occasional rupture Scoliosis Pes planus (flatfoot) Molluscoid pseudotumors (calcified hematomas) may be associated with scars Inheritance Autosomal dominant single-gene disorder Etiology [en.wikibooks.org]
Ongoing controversies regarding etiology, diagnosis, treatment Neurosurgical complications, including Chiari malformation, craniocervical instability and cervical instability, as well as occult tethered cord, have only recently been associated with Ehlers-Danlos [clinicaladvisor.com]
The usual medical culture perceives a disease as an entity that has an etiological basis, which presents a characteristic clinical picture, and which requires appropriate treatment. [avensonline.org]
Epidemiology
Conclusion Ehlers-Danlos disease has been widely underestimated from epidemiological point of view (this is not a rare disease, it is common), severity (patients who suffer from it are fragile and often socially excluded) and transmission (it is systematic [omicsonline.org]
A brief history of the disease is presented along with the epidemiology and characteristics of the 8 main phenotypes of the syndrome. [cda-adc.ca]
Epidemiology Frequency International Worldwide, more than 1.5 million people are diagnosed with Ehlers-Danlos syndrome (EDS). EDS (all types combined) is reported to have a 1 in 5,000-10,000 population frequency. [emedicine.medscape.com]
Pathophysiology
CCA is a rare condition, and there is limited understanding of its pathophysiology and treatment options. [acgcasereports.gi.org]
Morbidity in EDS is related to the primary pathophysiology and includes dislocations, pain, or both from chronic joint laxity and instability. [emedicine.medscape.com]
Vascular abnormalities in the placenta of Chst14-/- fetuses: implications in the pathophysiology of perinatal lethality of the murine model and vascular lesions in human CHST14/D4ST1 deficiency. [soar-rd.shinshu-u.ac.jp]
Prevention
How can Ehlers-Danos syndrome be prevented? Ehlers-Danlos syndrome is a hereditary disorder. Severe musculoskeletal manifestations may be prevented by avoiding high-impact physical exercise. [clinicaladvisor.com]
It also includes learning how to protect your joints and prevent injuries. [icd10data.com]
The major abnormality of coagulation in EDS type IV is decreased vascular wall reactivity which prevents slowing of the microcirculation and the accumulation of platelets needed for the formation of thrombus and haemostasis. 8 There are no reports of [academic.oup.com]
Ehlers-Danlos syndrome Department of Pedodontics and Preventive Dentistry, Dr. [jdrr.org]
Preventive measures in EDS will include consequent protection of the eye from trauma and definite therapy of the dry eye syndrome. [dog.org]