Medical Issues in Ehlers-Danlos Syndrome/Hypermobility Spectrum Disorders, Autism Spectrum Disorder, and Unaffected Controls
Objectives: To study clinical similarities between adults with EDS/HSD, ASD, and controls across key symptom areas to determine the extent of phenotypic overlap across these groups.
Methods: We surveyed 702 adults aged 25 years or older with or without EDS/HSD and/or ASD diagnoses on a variety of EDS/HSD-related health topics, including immune, autonomic, and endocrine symptomology; diagnostic clustering within affected families; hypermobility and occurrences of dislocations/subluxations of joints; skin abnormalities (e.g., bruising, scarring, bleeding); and chronic pain and fatigue.
Results: Compared to controls, the autism group reported similar though less severe symptomology than the EDS/HSD group, especially in areas of immune, autonomic, and endocrine dysregulation; skin abnormalities; and chronic pain. The ASD group did not significantly differ from controls in reported rates of generalized hypermobility unless already diagnosed with EDS/HSD. Interestingly, EDS/HSD mothers with autistic children reported more immune symptoms than EDS/HSD mothers without (p = 0.0119). The same trend was found in EDS/HSD mothers with EDS/HSD children (p = 0.0145), suggesting the maternal immune system may play an important role in both these conditions’ etiologies.
Conclusions: These data suggest that EDS/HSD and autism share some clinical, and perhaps etiological, overlap that should be further studied. This work also indicates that mild connective tissue impairment and chronic pain could be under-recognized issues in ASD that warrant further attention.