Evidence map›Paper›PMID 36756177›Full record

SynthesisFrontiers in medicine2023

Extracutaneous features and complications of the Ehlers-Danlos syndromes: A systematic review.

Brent J Doolan, Mark E Lavallee, Ingrid Hausser, Jane R Schubart, F Michael Pope, Suranjith L Seneviratne, Ingrid M Winship, Nigel P Burrows

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in Frontiers in medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
7.8field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Cases - Ehlers-Danlos syndromes: Review on the urologic implications.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2026
    Article
  4. Article
  5. Article
  6. Article
  7. Complex Wound Reconstruction in a Patient With Ehlers-Danlos Syndrome.Plastic and reconstructive surgery. Global open · 2025
    Article
  8. Article
  9. Review
  10. Article
  11. Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Article
  17. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 8 institutions in 5 countries.

Brent J DoolanSchool of Basic and Medical Biosciences, St. John's Institute of Dermatology, King's College London, London, United Kingdom.
Mark E LavalleeDepartment of Orthopedics, University of Pittsburgh Medical Center of Central PA, Pittsburgh, PA, United States.
Ingrid HausserInstitute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
Jane R SchubartDepartment of Surgery, Penn State College of Medicine, Hershey, PA, United States.
F Michael PopeDepartment of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust (West Middlesex University Hospital), London, United Kingdom.
Suranjith L SeneviratneInstitute of Immunity and Transplantation, Royal Free Hospital and University College London, London, United Kingdom.
Ingrid M WinshipDepartment of Genetic Medicine, The Royal Melbourne Hospital, Melbourne, VIC, Australia.
Nigel P BurrowsDepartment of Dermatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
Cambridge University Hospitals NHS Foundation Trust · GBChelsea and Westminster Hospital NHS Foundation Trust · GBKing's College London · GBPenn State Milton S. Hershey Medical Center · USThe Royal Melbourne Hospital · AUUniversity College London · GBUniversity Hospital Heidelberg · DEUniversity of Pittsburgh Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The Ehlers-Danlos syndromes (EDS) comprise a group of inherited connective tissue disorders presenting with variable fragility to skin, soft tissue, and certain internal organs, which can cause significant complications, particularly arterial rupture, bowel perforation and joint difficulties. Currently, there are 14 proposed subtypes of EDS, with all except one subtype (hypermobile EDS) having an identified genetic etiology. An understanding of the extracutaneous features and complications within each subtype is key to maximizing clinical care and reducing the risk of further complications. Methods: A systematic review of EDS-related extracutaneous features and complications was undertaken. Results: We identified 839 EDS cases that met the inclusion criteria. We noted a high prevalence of joint hypermobility amongst kyphoscoliotic (39/39, 100%), spondylodysplastic (24/25, 96.0%), and hypermobile (153/160, 95.6%) EDS subtypes. The most common musculoskeletal complications were decreased bone density (39/43, 90.7%), joint pain (217/270, 80.4%), and hypotonia/weakness (79/140, 56.4%). Vascular EDS presented with cerebrovascular events (25/153, 16.3%), aneurysm (77/245, 31.4%), arterial dissection/rupture (89/250, 35.5%), and pneumothorax/hemothorax. Chronic pain was the most common miscellaneous complication, disproportionately affecting hypermobile EDS patients (139/157, 88.5%). Hypermobile EDS cases also presented with chronic fatigue (61/63, 96.8%) and gastrointestinal complications (57/63, 90.5%). Neuropsychiatric complications were noted in almost all subtypes. Discussion: Understanding the extracutaneous features and complications of each EDS subtype may help diagnose and treat EDS prior to the development of substantial comorbidities and/or additional complications. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022308151, identifier CRD42022308151.

Indexed as

complicationsEhlers-Danlos syndromeextracutaneousheritable connective tissue disorders (HCTD)joint hypermobility

Identifiers

PMID36756177
PMCPMC9899794
OpenAlexW4317718216

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.