Health care supply in patients with Ehlers-Danlos syndromes and generalized hypermobility spectrum disorder: a German perspective

Abstract Background Diagnosing Ehlers-Danlos syndromes (EDS) and EDS-related “hypermobility spectrum disorder” (HSD) is challenging and cutaneous manifestations often serve as indicators of these rare connective tissue disorders. Only limited data exist on the healthcare of EDS/HSD in Germany as spe...

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Main Authors: Jonas Rauterberg, Marie Hock, Nikolaus Kernich, Arim Shukri, Henning Klapproth, Vanessa Löw, Michaela Henning, Iliana Tantcheva-Poór
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Orphanet Journal of Rare Diseases
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Online Access:https://doi.org/10.1186/s13023-025-03937-4
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author Jonas Rauterberg
Marie Hock
Nikolaus Kernich
Arim Shukri
Henning Klapproth
Vanessa Löw
Michaela Henning
Iliana Tantcheva-Poór
author_facet Jonas Rauterberg
Marie Hock
Nikolaus Kernich
Arim Shukri
Henning Klapproth
Vanessa Löw
Michaela Henning
Iliana Tantcheva-Poór
author_sort Jonas Rauterberg
collection DOAJ
description Abstract Background Diagnosing Ehlers-Danlos syndromes (EDS) and EDS-related “hypermobility spectrum disorder” (HSD) is challenging and cutaneous manifestations often serve as indicators of these rare connective tissue disorders. Only limited data exist on the healthcare of EDS/HSD in Germany as specialized services have been missing and a national register is not available. Objectives In 2020, a dermatologic-orthopedic EDS outpatient service was initiated at the University Hospital of Cologne, Germany. The objectives of the present survey were to examine the “medical journey” and the disease burden of our patients. Methods A pseudonymized paper survey was sent to all adults who were diagnosed with hypermobile EDS (hEDS), classical EDS (cEDS), classical-like EDS (clEDS) or generalized HSD at the EDS Cologne service from December 2021 until May 2023. Results Of the 99 participants, 80 were diagnosed with hEDS/HSD, 16 with cEDS and 3 with clEDS. The mean time to diagnosis was 22.0 years (14.5 years for cEDS/clEDS vs. 23.0 years for hEDS/HSD). 24.2% of the participants had a recognized degree of disability of ≥ 50, the average sick leave in the last 3 months was 4.6 days for cEDS/clEDS and 21.3 days for hEDS/HSD. 44.9% of the hEDS/HSD patients reported on having at least four comorbidities compared to 21.1% in the cEDS/clEDS group (p = 0.023). At least 15 medical specialties were involved in the diagnostics and treatment of participants with multiple therapeutic modalities. Conclusions This is the first study providing an insight on the healthcare supply of EDS/HSD patients in Germany. Participants in our survey had a much longer “diagnostic journey” than the one in previous studies and suffered from high morbidity despite high healthcare utilization. Our results point to the urgent necessity of a better coordinated, multidisciplinary care for patients with these complex genodermatoses including innovative political structures, further research and international networking.
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spelling doaj-art-e7c352faa69f4d02b56d2fdca1e208112025-08-20T03:06:51ZengBMCOrphanet Journal of Rare Diseases1750-11722025-08-0120111010.1186/s13023-025-03937-4Health care supply in patients with Ehlers-Danlos syndromes and generalized hypermobility spectrum disorder: a German perspectiveJonas Rauterberg0Marie Hock1Nikolaus Kernich2Arim Shukri3Henning Klapproth4Vanessa Löw5Michaela Henning6Iliana Tantcheva-Poór7Department of Dermatology and Venereology, Faculty of Medicine and University Hospital, University of CologneDepartment of Dermatology and Venereology, Faculty of Medicine and University Hospital, University of CologneDepartment of Orthopedic and Trauma Surgery, Faculty of Medicine, University Hospital of Cologne, University of CologneInstitute of Health and Economics and Clinical Epidemiology, University of CologneDepartment of Dermatology and Venereology, Faculty of Medicine and University Hospital, University of ColognePain Center, Department of Anesthesiology and Intensive Care Medicine, University of CologneDepartment of Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital, University of CologneDepartment of Dermatology and Venereology, Faculty of Medicine and University Hospital, University of CologneAbstract Background Diagnosing Ehlers-Danlos syndromes (EDS) and EDS-related “hypermobility spectrum disorder” (HSD) is challenging and cutaneous manifestations often serve as indicators of these rare connective tissue disorders. Only limited data exist on the healthcare of EDS/HSD in Germany as specialized services have been missing and a national register is not available. Objectives In 2020, a dermatologic-orthopedic EDS outpatient service was initiated at the University Hospital of Cologne, Germany. The objectives of the present survey were to examine the “medical journey” and the disease burden of our patients. Methods A pseudonymized paper survey was sent to all adults who were diagnosed with hypermobile EDS (hEDS), classical EDS (cEDS), classical-like EDS (clEDS) or generalized HSD at the EDS Cologne service from December 2021 until May 2023. Results Of the 99 participants, 80 were diagnosed with hEDS/HSD, 16 with cEDS and 3 with clEDS. The mean time to diagnosis was 22.0 years (14.5 years for cEDS/clEDS vs. 23.0 years for hEDS/HSD). 24.2% of the participants had a recognized degree of disability of ≥ 50, the average sick leave in the last 3 months was 4.6 days for cEDS/clEDS and 21.3 days for hEDS/HSD. 44.9% of the hEDS/HSD patients reported on having at least four comorbidities compared to 21.1% in the cEDS/clEDS group (p = 0.023). At least 15 medical specialties were involved in the diagnostics and treatment of participants with multiple therapeutic modalities. Conclusions This is the first study providing an insight on the healthcare supply of EDS/HSD patients in Germany. Participants in our survey had a much longer “diagnostic journey” than the one in previous studies and suffered from high morbidity despite high healthcare utilization. Our results point to the urgent necessity of a better coordinated, multidisciplinary care for patients with these complex genodermatoses including innovative political structures, further research and international networking.https://doi.org/10.1186/s13023-025-03937-4Hereditary connective skin disordersGenodermatosesEhlers-danlos syndromesHypermobility spectrum disorderGeneralized hypermobilityHealth care supply
spellingShingle Jonas Rauterberg
Marie Hock
Nikolaus Kernich
Arim Shukri
Henning Klapproth
Vanessa Löw
Michaela Henning
Iliana Tantcheva-Poór
Health care supply in patients with Ehlers-Danlos syndromes and generalized hypermobility spectrum disorder: a German perspective
Orphanet Journal of Rare Diseases
Hereditary connective skin disorders
Genodermatoses
Ehlers-danlos syndromes
Hypermobility spectrum disorder
Generalized hypermobility
Health care supply
title Health care supply in patients with Ehlers-Danlos syndromes and generalized hypermobility spectrum disorder: a German perspective
title_full Health care supply in patients with Ehlers-Danlos syndromes and generalized hypermobility spectrum disorder: a German perspective
title_fullStr Health care supply in patients with Ehlers-Danlos syndromes and generalized hypermobility spectrum disorder: a German perspective
title_full_unstemmed Health care supply in patients with Ehlers-Danlos syndromes and generalized hypermobility spectrum disorder: a German perspective
title_short Health care supply in patients with Ehlers-Danlos syndromes and generalized hypermobility spectrum disorder: a German perspective
title_sort health care supply in patients with ehlers danlos syndromes and generalized hypermobility spectrum disorder a german perspective
topic Hereditary connective skin disorders
Genodermatoses
Ehlers-danlos syndromes
Hypermobility spectrum disorder
Generalized hypermobility
Health care supply
url https://doi.org/10.1186/s13023-025-03937-4
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