2026-06-17 | Ciprofloxacin Exposure Promotes Aortic Dissection and Arterial Rupture in a Mouse Model of Vascular Ehlers-Danlos Syndrome.
We tested the hypothesis that ciprofloxacin exposure increases the incidence of aortic dissection and arterial rupture in vEDS mice. While data support that fluoroquinolones exacerbate lethal sequela in some types of aortic pathology, the potential danger of these drugs has not been studied in the context of vascular Ehlers-Danlos syndrome (vEDS). Eight-week-old male and female vEDS mice (Col3a1[G209S/WT]) and wild-type littermates (Col3a1[WT/WT]) were randomly assigned to receive either ciprofloxacin (n=25) or vehicle control (n=24) through daily gavage for 2 weeks and were monitored for 4 weeks. We compared groups based on survival, aortic dissection and rupture incidence, and aortic tissue levels of collagen, lysyl oxidase (LOX), matrix metalloproteinases (MMP), macrophages, and apoptosis. All vEDS mice that received vehicle and all littermate controls survived the 4-week study period. In contrast, 44% of vEDS mice that received ciprofloxacin died (P<0.001) due to aortic or arterial rupture manifesting as hemopericardium or hemothorax, most within 7 days of exposure. Findings were similar in male and female vEDS mice. Compared to aortic tissue from vehicle-treated vEDS mice, tissue from ciprofloxacin-treated vEDS mice exhibited decreased collagen content, decreased LOX, increased MMP 2 and 9 levels, increased macrophage infiltration, and increased apoptosis (all P<0.001). In a mouse model of vEDS, ciprofloxacin exposure resulted in aortic inflammation, collagen disruption, cell death, reduced LOX, and increased risk of fatal dissection and rupture of the aorta and branch arteries. These novel translational findings strongly support recommendations to avoid fluoroquinolones in patients with vEDS.
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2026-05-22 | Lateral Circumflex Femoral Artery Pseudoaneurysm Post-Hip Arthroscopy and Periacetabular Osteotomy in Ehlers-Danlos Syndrome: A Case Report.
An 18-year-old woman with Ehlers-Danlos syndrome developed subacute thigh pain on postoperative day 21 following elective hip arthroscopy and a periacetabular osteotomy. Doppler ultrasound revealed a pulsatile "yin-yang" lesion in the rectus femoris, and CT angiography confirmed a pseudoaneurysm of the lateral circumflex femoral artery with an arteriovenous fistula. Endovascular coil embolization with thrombin injection achieved complete thrombosis and symptom resolution. Vascular injury, though rare, should be considered after hip arthroscopy in patients with connective tissue disorders. Early multimodal imaging enables timely diagnosis, and minimally invasive endovascular treatment can provide definitive management with low morbidity.
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2026-04-21 | How can manual therapy be used to manage symptoms of Ehlers-Danlos Syndrome?
Manual therapy is used to manage symptoms of Ehlers-Danlos Syndrome, especially hypermobility types, but the evidence supporting its use is not as robust as for therapeutic exercises. Its role may be supportive, but more research is needed to adequately evaluate its effectiveness.
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