HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Does Joint Hypermobility Develop In Patients With Scleroderma?

default
Posted on Mon, 12 Oct 2015
Question: History: I had a positive test for diffuse scleroderma and a rheumatologist also diagnosed me with type III EDS. This was in 2008. Since then, I have had several tests done, MRI, ultrasound of my heart, pulmonary function tests, blood work and everything else. I recently saw a neurologist for nerve issues. These test let me no where in finding out why on earth I have so much pain- random in nature, like someone has a voodoo doll of me. Eventually I was told I had Fibromyalgia even though I seemingly have all the symptoms. This was my last straw. Not because I feel devastated over a diagnosis of fibromyalgia but because I have a difficult time believing in it.

Chief Complaint: As of the past 3 months, I have been experiencing chest pain and strange deep, almost bazaar pain in my abdomen. These chest pains are random in nature and present no associated evidence of panic or anxiety. I also have what feels like nerve pain on several areas, one being my trigeminal nerve (I had an MRI with MS cuts with - results) and down my leg which caused weakness. I do on occasion have what feels like pressure behind my eyes.

My question: with a positive ANA and positive SCL-70 (I think this was the test name) in addition to class III EDS, is it really possible to have both- they seem to not parallel in nature when looking into the collagen denominator between the 2. With my resent complains and symptoms of chest pain and abdomen issues, can I be developing Vascular EDS? I ask this because while I did not have a "click" in my heart back in 2008 when I saw a doc, he advised to keep an eye on this.

Important Factor: I have symptoms of EDS- not scleroderma. I have a - arch in most of my joints and had to have my ACL replaced in 2008 using a cadaver and not my gracilis like typical ACL surgeries. I tend to be more flexible than most 42 year olds. I have a higher heart rate at rest, 100-115 and lower at times. No high blood pressure. My 2 kids are now showing some symptoms of EDS- my daughter also complaining of chest pains and IBS like me. They both have hyper XXXXXXX joints and very high oral arches. If you look at my grandfather, he died of an embolism in his stomach. My mother, while neither of them diagnosed has the "thin skin, small, thin lips and narrow nose, small in statue and very thin hair" associated with EDS. My mother also has scoliosis of the spine.

I was in the ER a few months ago with bronchial spasms due to the flu. They did an EKG and the ER nurse/Doctor advised me to mention at some point that there was some "irregularities" in the findings but unrelated to my visit. (apparently if I am not being seen for heart issues, they wont address it even if it was not "normal)

I appreciate your time. Thanks- Carrie
doctor
Answered by Dr. Naval Mendiratta (30 minutes later)
Brief Answer:
EDS with Scleroderma Overlap

Detailed Answer:
Good evening

Thank you for writing on health care magic

Well, your case is a very rare one. I looked up on the net and only few cases in the world have been reported where they showed Joint hypermobility in patients with scleroderma, who are expected to have tight skin with restricted mobility. Which is overpowering the other? Hard to say.

But in your case, the joints are still very XXXXXXX despite diffuse scleroderma which is a very good thing. Always better to have hypermobile joints than the restricted ones.

2. As for your chest pain and abdominal pain, it may be a different cause than EDS. It is very less likely that you will develop Vascular EDS as it would have happened already by now if it had too. Lot of aneurysms everywhere it can form. But both the EDS are genetic in nature. So, if you didnt have vascular EDS in the beginning you dont have genes for it. It would not progress from Type III to type IV/V.

As per your chest pain and abdominal pain, I would like to firstly sort out your chest issues, that is Interstial Lung disease. In diffuse scleroderma, it s a very high possibility that you develop it in due course of time. Secondly, you need to get a 2 D Echo done to look for the heart pressures. Scleroderma can have Pulmonary ARtery Hypertension as well, which can cause chest pain without being diagnosed.

3. As for abdominal pain, I would like to know if you have been having loose stools or constipation. ??Consider starting on a probiotic

4. What medications are you on for scleroderma? and what all is the organ involvement?

DO let me know these queries

I hope the information was useful

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Naval Mendiratta (28 minutes later)
Very good to know. Thank you.

I am not taking any meds for the Scleroderma. I have no symptoms of it.

I take a daily dose of probiotic- I usually have normal BM's. I had a colonoscopy last year which was normal. (I think- they were looking for the usual- no polyps.)

I have never had blood work or genetic testing done for EDS III- I wonder if I have always had the vascular part and didn't know? Could the doc see it as III and because I didn't have symptoms of vascular, I was categorized as class III? I don't know if that is possible.

Thanks again for the confirmation of a few things I had questions on. Perhaps I don't have EDS at all. Is there another autoimmune disease that could mimic a + SCL-70 test result?
doctor
Answered by Dr. Naval Mendiratta (30 hours later)
Brief Answer:
Scleroderma

Detailed Answer:
good evening

sorry for the delayed reply as I had my wife s delivery..so was stuck in that

Well , EDS is as such a very beningn condition and doesn't affect much of the organs. except mitral valve prolapse. So once 2D echo is sufficient. vascular EDS would have presented by now and caused multiple aneurysms by now. so if it hasn't caused any symptoms till now doubtful it would..

As for scleroderma i would like to know the symptoms you had initially for which you were investigated. just having antibody positive doesn't mean scleroderma unless you had clinical symptoms as well. once symptoms are there, then only you need treatment. lot of time these antibodies can be falsely positive.

but if you are symptom free, you don't need much treatment. lof of times these antibodies can be falsely positive.

do let me know these queries

sorry again for delayed reply

regards
dr naval
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 754 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Does Joint Hypermobility Develop In Patients With Scleroderma?

Brief Answer: EDS with Scleroderma Overlap Detailed Answer: Good evening Thank you for writing on health care magic Well, your case is a very rare one. I looked up on the net and only few cases in the world have been reported where they showed Joint hypermobility in patients with scleroderma, who are expected to have tight skin with restricted mobility. Which is overpowering the other? Hard to say. But in your case, the joints are still very XXXXXXX despite diffuse scleroderma which is a very good thing. Always better to have hypermobile joints than the restricted ones. 2. As for your chest pain and abdominal pain, it may be a different cause than EDS. It is very less likely that you will develop Vascular EDS as it would have happened already by now if it had too. Lot of aneurysms everywhere it can form. But both the EDS are genetic in nature. So, if you didnt have vascular EDS in the beginning you dont have genes for it. It would not progress from Type III to type IV/V. As per your chest pain and abdominal pain, I would like to firstly sort out your chest issues, that is Interstial Lung disease. In diffuse scleroderma, it s a very high possibility that you develop it in due course of time. Secondly, you need to get a 2 D Echo done to look for the heart pressures. Scleroderma can have Pulmonary ARtery Hypertension as well, which can cause chest pain without being diagnosed. 3. As for abdominal pain, I would like to know if you have been having loose stools or constipation. ??Consider starting on a probiotic 4. What medications are you on for scleroderma? and what all is the organ involvement? DO let me know these queries I hope the information was useful Regards Dr Naval