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Evidence of Altered Enteric Nervous System Structure Associated With Severe Dysmotility in a Patient With Ehlers-Danlos Syndrome

Oelerich K, Bains K, Minchenberg SB, Deshpande V, Iturrino-Moreda J, Kulkarni S

ACG case reports journal, 2025

Abstract

Patients with Ehlers-Danlos syndrome (EDS) suffer from gastroparesis, constipation, and gut dysmotility. We present a case of histopathological assessment of the enteric nervous system from an EDS patient with severe gut dysmotility. Full-thickness small bowel biopsies with immunostains for c-kit and S-100 within the myenteric plexus revealed no significant abnormality. Using the method by Boschetti et al of Neuronal Specific Enolase-based immunostaining, we found that interganglionic distance in the myenteric plexus (∼800 um) exceeded the normal range (380-570 µm). This clinical experience provides rationale for pursuing histopathology in patients with EDS.

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