DOI: 10.12890/2024_005018

Coexistence of vascular Ehlers-Danlos syndrome and sticky platelet syndrome: a lethal combination in a young patient with thrombophilia and haemorrhagic diathesis

Authors

  • Manuel De Miguel-Escribano Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Seville, Spain
  • Manuel Garrido-Montes Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Seville, Spain
  • Pablo Astudillo-Ortega Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Seville, Spain
  • Roberto Pertusa-Mataix Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Seville, Spain
  • Andrea Rodríguez-Trigueros Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Seville, Spain
  • Jorge Corchero-Gijón Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Seville, Spain
  • Jose-Salvador Garcia-Morillo Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Seville, Spain

mdemiguelescribano@gmail.com

Keywords

Elhers-Danlos syndrome, sticky platelet syndrome, coagulopathy, bleeding diathesis, hypercoagulability

Abstract

Background: The coexistence of hypercoagulability and bleeding diathesis in the same patient represents a potentially lethal combination due to its complex management. Vascular Ehlers-Danlos syndrome (vEDS) and sticky platelet syndrome (SPS) are classified as rare diseases due to their low prevalence. vEDS is associated with bleeding tendencies caused by vascular wall fragility, while SPS is characterized by atypical arterial and venous thrombosis.
Case Report: We report a 27-year-old woman, smoker and regular consumer of energy drinks, with a medical history of subclinical hypothyroidism, minor thalassemia, recurrent joint sprains, high myopia, and anterior mitral valve prolapse, who was diagnosed with both vEDS and SPS type I. The patient experienced a catastrophic progression over a short time period, marked by numerous thrombotic and bleeding episodes, ultimately leading to a fatal outcome.
Conclusions: This report documents the first known case of concurrent vEDS and SPS, highlighting the complexity and challenges in the management of these two rare conditions together. The interplay between these syndromes necessitates careful clinical consideration and the development of tailored management strategies to mitigate associated risks. This underscores the crucial role of the internist in overseeing such cases. Further studies are needed to explore new therapeutic strategies aimed at improving survival rates and outcomes for patients with this unique combination of disorders.

View the entire article

Downloads

References

  1. Lum YW, Brooke BS, Black JH 3rd. Contemporary management of vascular Ehlers-Danlos syndrome. Curr Opin Cardiol 2011;26:494-501.
  2. Pepin M, Schwarze U, Superti-Furga A, Byers PH. Clinical and genetic features of Ehlers-Danlos syndrome type IV, the vascular type. N Engl J Med 2000;342:673-680.
  3. Frank M, Albuisson J, Ranque B, Golmard L, Mazzella JM, Bal-Theoleyre L, et al. The type of variants at the COL3A1 gene associates with the phenotype and severity of vascular Ehlers-Danlos syndrome. Eur J Hum Genet 2015;23:1657-1664.
  4. Demirdas S, van den Bersselaar LM, Lechner R, Bos J, Alsters SIM, Baars MJH, et al. Vascular Ehlers-Danlos Syndrome: A Comprehensive Natural History Study in a Dutch National Cohort of 142 Patients. Circ Genom Precis Med 2024;17:e003978.
  5. Minutti-Zanella C, Villarreal-Martínez L, Ruiz-Argüelles GJ. Primary Thrombophilia XVII: A Narrative Review of Sticky Platelet Syndrome in México. J Clin Med 2022;11:4100.
  6. Buso G, Corvini F, Fusco EM, Messina M, Cherubini F, Laera N et al. Current Evidence and Future Perspectives in the Medical Management of Vascular Ehlers-Danlos Syndrome: Focus on Vascular Prevention. J Clin Med 2024;13:4255.
  7. Byers PH, Belmont J, Black J, De Backer J, Frank M, Jeunemaitre X, et al. Diagnosis, natural history, and management in vascular Ehlers-Danlos syndrome. Am J Med Genet C Semin Med Genet 2017;175:40-47.
  8. Boon RA, Seeger T, Heydt S, Fischer A, Hergenreider E, Horrevoets AJ, et al. MicroRNA-29 in aortic dilation: implications for aneurysm formation. Circ Res 2011;109:1115-1119.
  9. Lum YW, Brooke BS, Arnaoutakis GJ, Williams TK, Black JH 3rd. Endovascular procedures in patients with Ehlers-Danlos syndrome: a review of clinical outcomes and iatrogenic complications. Ann Vasc Surg 2012;26:25-33.
  10. Kubisz P, Holly P, Stasko J. Sticky Platelet Syndrome: 35 Years of Growing Evidence. Semin Thromb Hemost 2019;45:61-68.
  11. Busch A, Hoffjan S, Bergmann F, Hartung B, Jung H, Hanel D et al. Vascular type Ehlers-Danlos syndrome is associated with platelet dysfunction and low vitamin D serum concentration. Orphanet J Rare Dis 2016;11:111.

Published

2024-11-28

How to Cite

1.
De Miguel-Escribano M, Garrido-Montes M, Astudillo-Ortega P, Pertusa-Mataix R, Rodríguez-Trigueros A, Corchero-Gijón J, et al. Coexistence of vascular Ehlers-Danlos syndrome and sticky platelet syndrome: a lethal combination in a young patient with thrombophilia and haemorrhagic diathesis. EJCRIM [Internet]. 2024 Nov. 28 [cited 2026 Nov. 3];11(12). Available from: https://ejcrim.com/index.php/ejcrim/article/view/5018