Overview
- Ehlers-Danlos Syndromes (EDS) are a clinically and genetically heterogeneous group of connective-tissue disorders, where the genetic defect affects collagen and connective-tissue synthesis and structure. It is characterized by hypermobility, cutaneous fragility and hyperextensibility. Since the connective tissue is the tissue that helps body growth as well as serving as a scaffold for cells and organs, Ehlers-Danlos is a pleiotropic syndrome affecting the skin, joints and blood vessels. It has been classically divided into six types (classical, hypermobile, vascular, kyphoscoliotic, arthrochalasis and dermatosparaxis), where the underlying collagen abnormality is different for each type. In some cases, EDS can be life threatening, whereas in others, individuals live a relatively uneventful life. EDS can have phenotypic overlap with conditions such as Marfan disease and cutis laxa.
- The Igenomix Ehlers-Danlos Syndrome Precision Panel can be used to make an accurate and directed diagnosis as well as a differential diagnosis of connective tissue disorders due to their overlapping phenotypic features ultimately leading to a better management and prognosis of the disease. It provides a comprehensive analysis of the genes involved in this disease using next-generation sequencing (NGS) to fully understand the spectrum of relevant genes involved.
Indication
- The Igenomix Ehlers-Danlos Syndrome Precision Panel is indicated for those patients with a clinical suspicion or diagnosis of EDS presenting with:
- Skin hyperextensibility
- Joint Hypermobility
- Easy bruising
- Retinal detachment
- Mitral valve prolapse
- Hernias and organ prolapse
- Skeletal abnormalities: pectus excavatum, high arched palate, pes planus
- Digestive problems: heartburn and constipation
- Urinary stress incontinence
Clinical Utility
The clinical utility of this panel is:
- The genetic and molecular confirmation for an accurate clinical diagnosis of a symptomatic patient. Clinical overlap exists between different EDS subtypes, as well as with other heritable connective tissue disorders, therefore the diagnosis relies on molecular confirmation with genetic identification of causative genes.
- Early initiation of treatment with a multidisciplinary team in the form of physical therapy and surveillance to prevent vascular complications.
- Risk assessment and genetic counselling of asymptomatic family members according to the mode of inheritance.
- Improvement of delineation of genotype-phenotype correlation.
References
Scheper MC, Nicholson LL, Adams RD, Tofts L, Pacey V. The natural history of children with joint hypermobility syndrome and Ehlers-Danlos hypermobility type: a longitudinal cohort study. Rheumatology (Oxford).
Malfait, F., Wenstrup, R. J., & De Paepe, A. (2010). Clinical and genetic aspects of Ehlers-Danlos syndrome, classic type. Genetics in medicine: official journal of the American College of Medical Genetics, 12(10), 597–605. https://doi.org/10.1097/GIM.0b013e3181eed412
Malfait, F., Francomano, C., Byers, P., Belmont, J., Berglund, B., Black, J., Bloom, L., Bowen, J. M., Brady, A. F., Burrows, N. P., Castori, M., Cohen, H., Colombi, M., Demirdas, S., De Backer, J., De Paepe, A., Fournel-Gigleux, S., Frank, M., Ghali, N., Giunta, C., … Tinkle, B. (2017). The 2017 international classification of the Ehlers-Danlos syndromes. American journal of medical genetics. Part C, Seminars in medical genetics, 175(1), 8–26. https://doi.org/10.1002/ajmg.c.31552
De Paepe, A., & Malfait, F. (2012). The Ehlers-Danlos syndrome, a disorder with many faces. Clinical genetics, 82(1), 1–11. https://doi.org/10.1111/j.1399-0004.2012.01858.x
Ritelli, M., & Colombi, M. (2020). Molecular Genetics and Pathogenesis of Ehlers-Danlos Syndrome and Related Connective Tissue Disorders. Genes, 11(5), 547. https://doi.org/10.3390/genes11050547
Miller, E., & Grosel, J. M. (2020). A review of Ehlers-Danlos syndrome. JAAPA : official journal of the American Academy of Physician Assistants, 33(4), 23–28. https://doi.org/10.1097/01.JAA.0000657160.48246.91