OpenHealth Q&A

Exploring Potential Diagnoses: Connective Tissue Disorder or Neurodevelopmental Syndrome?

I am a 20-year-old female, standing at 5'2" and weighing 229 pounds, with a background of being White and ethnically Italian. I have been diagnosed with several health issues, including Autism Spectrum Disorder, Postural Orthostatic Tachycardia Syndrome (POTS), and Obstructive Sleep Apnea (OSA). Additionally, I experience mild iron deficiency anemia as well as Generalized Anxiety Disorder and Major Depressive Disorder. I am seeking insights, particularly from geneticists and other medical professionals, regarding my condition as my geneticist was unable to provide a definitive diagnosis. I have already undergone a comprehensive genetic test, the results of which are pending, but I would like to narrow down the potential causes based on my symptoms. During my physical examination, my geneticist noted the following observations: Brachydactyly—characterized by shortened fingers (specific type not mentioned); Clinodactyly of the fifth finger; bilateral flatfoot; Piezogenic Papules on my heels; a Beighton score of 7 out of 9; and stretch marks located on my abdomen, back, and inner arms/cubital fossa. In addition to these, I have reported a variety of other symptoms, including Strabismus, Myopia, Astigmatism, and Blue Sclera. I also have Lumbar Hyperlordosis, frequent subluxations, particularly in my wrists, and isolated ligament sprains that occur without any apparent trauma. I bruise easily on the front of my legs and have a severe underbite. Under anesthesia, I encountered airway collapse, necessitating multiple attempts to secure an airway tube. Furthermore, I experience difficulties with swallowing and have been diagnosed with TMJ by an orthodontist during childhood. My teeth are often widely spaced, a condition exacerbated by previous braces. As a child, I experienced numerous ear infections and suffer from recurrent toe infections if I neglect to trim my toenails correctly. Additionally, my body showcases a weak pelvic floor, worsened after a cesarean section 11 months ago. I have trace regurgitation in my mitral, tricuspid, and pulmonic valves, and have dealt with chronic constipation since childhood. At age 12, I was diagnosed with a twisted disc in my spine. I have a prominent vein in my right arm that is routinely difficult to puncture for medical purposes. I frequently endure headaches and neck instability, and my body displays iron and vitamin D deficiencies. I also experience neuropathy, where even slight pressure leads to numbness in my extremities; for instance, holding a pen for a short period can cause numbness in my fingers, and I often wake with one arm completely numb. I have had two significant back falls that compromised my breathing. My Autism presented behavioral challenges in childhood, accompanied by some delay in motor skills. Additionally, severe joint pain, particularly in my back, arises after merely walking or standing for short intervals. During my pregnancy, complications arose as my membranes ruptured at 38 weeks and 5 days; I was administered an epidural and later received Pitocin to expedite labor, which ultimately resulted in an emergency cesarean section due to fetal heart rate decelerations (the umbilical cord was wrapped around my baby’s neck, but he stabilized well afterward and avoided NICU admission). Postpartum, I experienced significant bleeding with large clots and was placed on blood thinners to mitigate the risk of Deep Vein Thrombosis (DVT). Blood tests during pregnancy indicated a positive result for Klinefelter's syndrome; however, follow-up testing confirmed a negative result for my child. My cognitive abilities are average, and aside from minor cupping on my ears, I do not exhibit any distinctive craniofacial features. While I feel my symptoms are mild compared to the typical presentations of connective tissue disorders, my lack of prominent craniofacial characteristics and average head circumference leave me uncertain about my diagnosis. I would appreciate any guidance or insights into what I may be facing.

Answers (1)

9/14/2025, 1:10:43 AM

OpenHealth AI

It sounds like you are dealing with a complex interplay of symptoms, and it’s understandable to seek clarity on your health concerns. Your medical history suggests a possible connective tissue disorder, but it is also crucial to consider other underlying conditions that could be contributing to your overall clinical picture.

Main Points:

1. Your symptoms may suggest a connective tissue disorder like Ehlers-Danlos syndrome (EDS) or another dysautonomia-related condition.
2. Genetic testing is important to confirm a diagnosis.
3. Managing symptoms and improving quality of life is essential during this process.

Explanation

Several of your symptoms, such as hypermobility (indicated by your Beighton score), easy bruising, joint instability, and skin issues (like stretch marks and piezogenic papules), point towards a possible connective tissue disorder. The brachydactyly, clinodactyly, and other musculoskeletal symptoms could also align with these conditions. Ehlers-Danlos syndrome, particularly the hypermobile type, can be associated with symptoms like joint pain and autonomic nervous system anomalies (like POTS).

Your gastrointestinal and neurological symptoms may further complicate the picture, and it's essential to coordinate care among multiple specialists, including a geneticist, rheumatologist, and possibly a neurologist or a gastroenterologist.

Next Steps

1. Pursue Genetic Testing Results: Once the results return, share them with your healthcare providers to help identify if there is a hereditary connective tissue disorder or another genetic condition at play.

2. Document Symptoms: Keep a detailed log of your symptoms, including when they occur, their severity, and any triggers you notice. This can help your doctors find patterns and provide better-targeted treatments.

3. Seek Multidisciplinary Medical Care:

   • Consult with a rheumatologist for a thorough evaluation of your connective tissue symptoms.
   • A neurologist might help with your neuropathy and any issues related to your autonomic nervous system.
   • Enrollment in a physical therapy program can assist with managing pain, improving mobility, and strengthening your pelvic floor.
   • A gastroenterologist can assist with constipation and swallowing difficulties, ensuring those issues are well managed.

4. Symptom Management:

   • For anxiety and depression, ensure you have access to mental health support.
   • Maintain hydration and a balanced diet, focusing on iron and vitamin D-rich foods to help manage deficiencies.
   • Gentle exercises tailored to your capabilities can help with muscle tone and potentially alleviate some joint pain.

5. Consider Lifestyle Adjustments: Focus on preventive measures, such as proper footwear and ergonomic adjustments for your daily activities to minimize joint strain and manage any orthostatic symptoms effectively.

Your concerns are valid, and it’s wise to seek clarity about your health. Continuous communication with your healthcare team will be crucial as you navigate these complex symptoms. I'm here if you need further information or support.