When researchers, observers, and hypothesizers begin to make connections, it can become very interesting.  I recently came across listings for research studies which involve patients living with one of two disorders: multiple sclerosis and Ehlers-Danlos syndrome. 

What is Ehlers-Danlos Syndrome?

Ehlers-Danlos syndrome (EDS) is the name given to a diverse group of inherited connective tissue disorders involving a genetic defect in collagen.  Ehlers-Danlos syndrome, characterized by joint hypermobility, skin extensibility and tissue fragility, can affect the skin, joints, and blood vessels.  The prevalence of EDS is estimated to be approximately 1 in 400,000 in the United States, but mild cases may be under diagnosed.  In comparison, prevalence of MS is estimated to be approximately 90 in 100,000 in the United States according to the Cleveland Clinic.

There are 11 variants of EDS which have been identified to date, each with differences in genetic, biochemical, and clinical presentation.  The specific collagen defect has been identified in only six of 11 variants or types of EDS.  Overlap between variants is common and more than one third of persons with EDS do not clearly fit into a single type. 

One type of Ehlers-Danlos syndrome, Type IV, is severe and life-threatening due to spontaneous arterial rupture or the perforation of internal organs.  Type VI is also dangerous, but very rare.  Other types of EDS are usually not as dangerous.  Patients can often life a healthy life, even if somewhat restricted. 

Is there a connection between EDS and MS?

Not much evidence is available to suggest that MS and EDs are somehow related, but I have one blogger friend who has been diagnosed with both conditions.  Just as people find my blog because I have MS and RA (and they are looking for information on both diseases), people searching the internet for information regarding multiple sclerosis and Ehlers-Danlos syndrome will find her blog, Life with MS and EDS.   

It is known that EDS has various neurological manifestations, including peripheral neuropathies, muscle weakness, impaired proprioception, and abnormality of gait.  More common are the vascular features, such as intracranial aneurysms, subarachnoid hemorrhage (bleeding between the brain and the thin tissues which cover the brain), and spontaneous arterial rupture.  Various congenital malformations of the vessels and brain anatomy have been reported.

A study published in 2008 suggests that patients with EDS may be more susceptible to developing MS. (Multiple Sclerosis 2008; 14 : 567—570)  Researchers report four MS patients out of 1,892 seen at MS outpatient clinics in Nottingham, UK, were diagnosed with both disorders.  Authors quote statistics on the prevalence of EDS in the general population as 1 in 5,000 (which is considerably higher than the stats listed above for the United States alone).  Thus, data collected by study authors based on this higher prevalence rate suggest that MS patients are 10 to 11 times more likely to have EDS than the general population.  Based on a lower prevalence rate, this increased susceptibility may be even higher.