Document Detail


Clinical and genetic features of Ehlers-Danlos syndrome type IV, the vascular type.
MedLine Citation:
PMID:  10706896     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Ehlers-Danlos syndrome type IV, the vascular type, results from mutations in the gene for type III procollagen (COL3A1). Affected patients are at risk for arterial, bowel, and uterine rupture, but the timing of these events, their frequency, and the course of the disease are not well documented. METHODS: We reviewed the clinical and family histories of and medical and surgical complications in 220 index patients with biochemically confirmed Ehlers-Danlos syndrome type IV and 199 of their affected relatives. We identified the underlying COL3A1 mutation in 135 index patients. RESULTS: Complications were rare in childhood; 25 percent of the index patients had a first complication by the age of 20 years, and more than 80 percent had had at least one complication by the age of 40. The calculated median survival of the entire cohort was 48 years. Most deaths resulted from arterial rupture. Bowel rupture, which often involved the sigmoid colon, accounted for about a quarter of complications but rarely led to death. Complications of pregnancy led to death in 12 of the 81 women who became pregnant. The types of complications were not associated with specific mutations in COL3A1. CONCLUSIONS: Although most affected patients survive the first and second major complications, Ehlers-Danlos syndrome type IV results in premature death. The diagnosis should be considered in young people who come to medical attention because of uterine rupture during pregnancy or arterial or visceral rupture.
Authors:
M Pepin; U Schwarze; A Superti-Furga; P H Byers
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The New England journal of medicine     Volume:  342     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-03-09     Completed Date:  2000-03-09     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  673-80     Citation Subset:  AIM; IM    
Affiliation:
Department of Pathology, University of Washington, Seattle 98195-7470, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Cause of Death
Child
Child, Preschool
Ehlers-Danlos Syndrome / complications*,  genetics,  mortality
Female
Genotype
Humans
Infant
Intestinal Perforation / etiology
Male
Middle Aged
Mutation
Phenotype
Pregnancy
Pregnancy Complications / etiology,  mortality
Pregnancy Outcome
Survival Analysis
Vascular Diseases / etiology
Grant Support
ID/Acronym/Agency:
AR 21557/AR/NIAMS NIH HHS
Comments/Corrections
Comment In:
N Engl J Med. 2000 Mar 9;342(10):730-2   [PMID:  10706904 ]
N Engl J Med. 2000 Aug 3;343(5):366; author reply 368   [PMID:  10928897 ]
N Engl J Med. 2000 Aug 3;343(5):366-8   [PMID:  10928898 ]
Erratum In:
N Engl J Med 2001 Feb 1;344(5):392

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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