Rare vascular complications in classical Ehlers-Danlos syndromes

Ehlers-Danlos syndromes (EDS) are a group of connective tissue disorders associated with skin, ligament, blood vessel and organ abnormalities. Skin hyperextensibility, joint hypermobility and widened atrophic scars are characteristic of classical EDS. Vascular complications, though rare in classical EDS, can be life-threatening, and this necessitates one to look for vascular associations in non-vascular, such as classical, forms of EDS due to the heterogeneity of the syndrome. Reports of vascular complications in classical EDS are often limited to haematomas being the most frequent manifestation. This case report discusses an elderly patient with genetically confirmed classical EDS who suffered from a series of pulmonary and vascular complications, including recurrent spontaneous haemopneumothorax, aortic dissection and eventual mesenteric haemorrhage, which resulted in his death. Identifying clinical red flags is crucial to predict such future catastrophic vascular events and guide appropriate counselling and management strategies for individuals with classical EDS.