title: Benign Joint Hypermobility Minimally Impacts Autonomic Abnormalities in Pediatric Subjects with Chronic Functional Pain Disorders.
abstract: To determine if children with benign joint hypermobility (BJH) syndrome and chronic functional pain disorders have more autonomic dysfunction.
  
  
  
  Retrospective chart review study of pediatric patients seen in the pediatric neurogastroenterology and autonomic clinic who underwent autonomic testing and had either a Beighton score of ≥6 and met Brighton criteria for BJH (with BJH) or a score of ≤2 (no BJH).
  
  
  
  Twenty-one female subjects (10 without BJH) met inclusion criteria; 64% of BJH had diagnosis confirmed by genetics consultation. We evaluated for postural tachycardia syndrome, syncope, orthostatic intolerance, and orthostatic hypotension. None of these diagnoses, as well as baseline heart rate, peak heart rate in first 10 minutes of head up tilt (P = .35 and P = .61, respectively), and sudomotor index (suggestive of autonomic neuropathy) (P = .58), showed differences between the groups. Age of onset of symptoms was also similar (P = .61) (BJH vs without BJH: median [range]:15.6 years [12.9-17.5] vs 15.4 years [11.1-18.2]). There was no difference between groups in complaints of migraine, chronic nausea, chronic fatigue, lightheadedness, dizziness, fainting >3 times/lifetime, delayed onset of sleep, irritable bowel syndrome, dyspepsia, abdominal migraine, functional abdominal pain, constipation, or fibromyalgia.
  
  
  
  Children with chronic functional pain disorders and BJH have autonomic testing findings and comorbid features compared with a similar cohort of subjects without BJH, suggesting that BJH is not the driver of the autonomic and comorbid disorders.
authors: Center for Pediatric Neurogastroenterology, Motility, and Autonomic Disorders, Medical College of Wisconsin, Milwaukee, WI.
authors: Gisela
authors: G
authors: Chelimsky
authors: Center for Pediatric Neurogastroenterology, Motility, and Autonomic Disorders, Medical College of Wisconsin, Milwaukee, WI.
authors: Katja
authors: K
authors: Kovacic
authors: Division of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, WI.
authors: Pippa
authors: P
authors: Simpson
authors: Division of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, WI.
authors: Melodee
authors: M
authors: Nugent
authors: Division of Pediatric Genetics, Medical College of Wisconsin, Milwaukee, WI.
authors: Donald
authors: D
authors: Basel
authors: Center for Pediatric Neurogastroenterology, Motility, and Autonomic Disorders, Medical College of Wisconsin, Milwaukee, WI.
authors: Julie
authors: J
authors: Banda
authors: Center for Pediatric Neurogastroenterology, Motility, and Autonomic Disorders, Medical College of Wisconsin, Milwaukee, WI; Department of Neurology, Medical College of Wisconsin, Milwaukee, WI.
authors: Thomas
authors: T
authors: Chelimsky
mesh_terms: D000293:Adolescent; D001341:Autonomic Nervous System / Q000503:physiopathology*; D002648:Child; D059350:Chronic Pain / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000150:complications / Q000503:physiopathology*; D012189:Retrospective Studies
keywords: Hypermobility; pediatrics; postural tachycardia syndrome