{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:29:37Z","timestamp":1760149777482,"version":"build-2065373602"},"reference-count":7,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T00:00:00Z","timestamp":1694822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["5R35GM142676-03"],"award-info":[{"award-number":["5R35GM142676-03"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Ehlers\u2013Danlos Syndrome (EDS) is a rare disease affecting the skin, joints, vasculature, and internal organs. Approximately 85% of those affected are categorized as the hypermobile type (hEDS), which is associated with numerous medical and psychiatric comorbidities, including chronic pain. Additionally, approximately 71% of patients with hEDS undergo at least one surgical procedure; however, indicators for surgery and pain outcomes after surgery are poorly understood. This preliminary study used a medical chart review to identify the frequency and nature of comorbidities in a cohort of adolescents and young adult patients with hEDS and a surgical history compared to those without a surgical history. Results showed that patients diagnosed with hEDS who underwent surgery reported significantly more comorbidities (e.g., CRPS, IBS, Fibromyalgia, POTS, hypothyroidism, etc.) than those who did not have surgery. Seventy percent of individuals who presented for surgery fell within the categories of orthopedic, gastrointestinal, or laparoscopic\/endometriosis-related surgeries. Identifying patients with hEDS who are at risk for needing surgery will help identify the mechanisms contributing to risk factors for poor surgical outcomes. The results of this study may be instructive in the management and care of hEDS patients undergoing surgery.<\/jats:p>","DOI":"10.3390\/children10091562","type":"journal-article","created":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T06:36:45Z","timestamp":1694932605000},"page":"1562","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Exploring Comorbidities in Adolescent and Young Adults with Hypermobile Ehlers\u2013Danlos Syndrome with and without a Surgical History: A Preliminary Investigation"],"prefix":"10.3390","volume":"10","author":[{"given":"Haley","family":"Gagnon","sequence":"first","affiliation":[{"name":"Biobehavioral Pain Innovations Laboratory, Department of Psychiatry & Behavioral Sciences, Boston Children\u2019s Hospital, Boston, MA 02115, USA"},{"name":"Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children\u2019s Hospital, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire E.","family":"Lunde","sequence":"additional","affiliation":[{"name":"Biobehavioral Pain Innovations Laboratory, Department of Psychiatry & Behavioral Sciences, Boston Children\u2019s Hospital, Boston, MA 02115, USA"},{"name":"Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children\u2019s Hospital, Boston, MA 02115, USA"},{"name":"Nuffield Department of Women\u2019s & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziyan","family":"Wu","sequence":"additional","affiliation":[{"name":"Biobehavioral Pain Innovations Laboratory, Department of Psychiatry & Behavioral Sciences, Boston Children\u2019s Hospital, Boston, MA 02115, USA"},{"name":"Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children\u2019s Hospital, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9187-3100","authenticated-orcid":false,"given":"Eduardo N.","family":"Novais","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Boston Children\u2019s Hospital, Boston, MA 02115, USA"},{"name":"Department of Orthopedic Surgery, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9825-0064","authenticated-orcid":false,"given":"David","family":"Borsook","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry and Radiology, Massachusetts General Hospital, Boston, MA 02114, USA"},{"name":"Department of Anesthesiology, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1696-0340","authenticated-orcid":false,"given":"Christine B.","family":"Sieberg","sequence":"additional","affiliation":[{"name":"Biobehavioral Pain Innovations Laboratory, Department of Psychiatry & Behavioral Sciences, Boston Children\u2019s Hospital, Boston, MA 02115, USA"},{"name":"Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children\u2019s Hospital, Boston, MA 02115, USA"},{"name":"Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1002\/ajmg.c.31538","article-title":"Hypermobile Ehlers-Danlos Syndrome (a.k.a. Ehlers-Danlos Syndrome Type III and Ehlers-Danlos Syndrome Hypermobility Type): Clinical Description and Natural History","volume":"175","author":"Tinkle","year":"2017","journal-title":"Am. J. Med. Genet. C Semin. Med. Genet."},{"key":"ref_2","unstructured":"Adam, M.P., Ardinger, H.H., Pagon, R.A., Wallace, S.E., Bean, L.J., Gripp, K.W., Mirzaa, G.M., and Amemiya, A. (1993). GeneReviews\u00ae, University of Washington, Seattle."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1002\/ajmg.c.31429","article-title":"Differential Diagnosis and Diagnostic Flow Chart of Joint Hypermobility Syndrome\/Ehlers-Danlos Syndrome Hypermobility Type Compared to Other Heritable Connective Tissue Disorders","volume":"169","author":"Colombi","year":"2015","journal-title":"Am. J. Med. Genet. C Semin. Med. Genet."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.neubiorev.2021.03.008","article-title":"Left to Themselves: Time to Target Chronic Pain in Childhood Rare Diseases","volume":"126","author":"Sieberg","year":"2021","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1016\/j.apmr.2011.01.016","article-title":"Medication, Surgery, and Physiotherapy among Patients with the Hypermobility Type of Ehlers-Danlos Syndrome","volume":"92","author":"Rombaut","year":"2011","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1080\/24740527.2021.2019576","article-title":"Preventing Pediatric Chronic Postsurgical Pain: Time for Increased Rigor","volume":"6","author":"Sieberg","year":"2022","journal-title":"Can. J. Pain."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.neuron.2012.01.001","article-title":"Understanding migraine through the lens of maladaptive stress responses: A model disease of allostatic load","volume":"73","author":"Borsook","year":"2012","journal-title":"Neuron"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/9\/1562\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:52:04Z","timestamp":1760129524000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/9\/1562"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,16]]},"references-count":7,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["children10091562"],"URL":"https:\/\/doi.org\/10.3390\/children10091562","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2023,9,16]]}}}