<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2306-4102</journal-id>
<journal-title><![CDATA[Acta ortopédica mexicana]]></journal-title>
<abbrev-journal-title><![CDATA[Acta ortop. mex]]></abbrev-journal-title>
<issn>2306-4102</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Ortopedia y Traumatología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2306-41022026000200085</article-id>
<article-id pub-id-type="doi">10.35366/123052</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Comorbidities in Ehlers-Danlos syndromes and hypermobile spectrum disorders]]></article-title>
<article-title xml:lang="es"><![CDATA[Comorbilidades en los síndromes de Ehlers-Danlos y los trastornos del espectro hipermóvil]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[TJ]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Serrano-Ardila]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Loma Linda University School of Medicine Department of Physical Medicine &amp; Rehabilitation]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>USA</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,The American British Cowdray Medical Center Department of Orthopedics ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2026</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2026</year>
</pub-date>
<volume>40</volume>
<numero>2</numero>
<fpage>85</fpage>
<lpage>88</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2306-41022026000200085&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2306-41022026000200085&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2306-41022026000200085&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  hypermobile spectrum disorders (HSD) and Ehlers-Danlos syndromes (EDS) are connective tissue disorders often associated with systemic manifestations such as mast cell activation syndrome (MCAS), postural orthostatic tachycardia syndrome (POTS), irritable bowel syndrome (IBS), and autoimmune conditions, including spondyloarthritis (SpA). The overlap of these conditions complicates diagnosis and treatment. This study investigates the prevalence of MCAS and other comorbidities, as well as patterns of medication use, in individuals with HSD/EDS.  Material and methods:  this cross-sectional study included 37 participants diagnosed with HSD or EDS based on the 2017 Diagnostic Consensus Criteria. Participants were divided into two groups: 23 with SpA + EDS and 14 with EDS-only. Demographic variables, comorbidities, and medication use (biologics, disease-modifying antirheumatic drugs [DMARDs], and nonsteroidal anti-inflammatory drugs [NSAIDs]) were analyzed using comparative statistical methods.  Results:  MCAS was significantly less prevalent in SpA + EDS participants (13%) compared to the EDS-only group (85.7%, p &lt; 0.0001). POTS (60.9% vs 78.6%) and IBS (60.9% vs 85.7%) occurred at similar frequencies in both groups. The use of immunomodulators was higher in SpA + EDS (73.9%) than EDS-only (42.8%, p = 0.003). Biologic use was more common in SpA + EDS (34.8% vs 7.1%, p = 0.050), whereas NSAID use was higher in EDS-only participants (47.4% vs 30.4%, p &gt; 0.05).  Conclusions:  the lower MCAS prevalence in SpA + EDS may reflect symptom overlap or suppression due to immunomodulatory treatments. Differences in medication use highlight variations in diagnostic and therapeutic strategies. Comprehensive evaluations are essential to ensure accurate diagnoses and optimal treatment approaches.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  los trastornos del espectro hipermóvil (TEH) y los síndromes de Ehlers-Danlos (SED) son trastornos del tejido conectivo asociados con manifestaciones sistémicas como el síndrome de activación mastocitaria (SAM), el síndrome de taquicardia ortostática postural (POTS), el síndrome de intestino irritable (SII) y enfermedades autoinmunes como la espondiloartritis (EspA). La superposición de estos trastornos dificulta el diagnóstico y tratamiento. Este estudio analiza la prevalencia de SAM y otras comorbilidades, así como los patrones de uso de medicamentos en pacientes con TEH/SED.  Material y métodos:  se realizó un estudio transversal con 37 participantes diagnosticados con TEH o SED según los Criterios de Consenso Diagnóstico de 2017. Los participantes fueron divididos en dos grupos: 23 con EspA + SED y 14 con SED sin EspA. Se recopilaron datos sobre variables demográficas, comorbilidades y uso de medicamentos, incluyendo biológicos, fármacos antirreumáticos modificadores de la enfermedad (FARME) y antiinflamatorios no esteroides (AINE). Se emplearon métodos estadísticos comparativos para el análisis.  Resultados:  la prevalencia de SAM fue significativamente menor en el grupo EspA + SED (13%) en comparación con el grupo SED sin EspA (85.7%, p &lt; 0.0001). La frecuencia de POTS (60.9 vs 78.6%) e SII (60.9 vs 85.7%) fue similar en ambos grupos. El uso de inmunomoduladores fue mayor en el grupo EspA + SED (73.9%) en comparación con el grupo SED sin EspA (42.8%, p = 0.003). El uso de biológicos fue más frecuente en EspA + SED (34.8 vs 7.1%, p = 0.050), mientras que el uso de AINE fue mayor en el grupo SED sin EspA (47.4 vs 30.4%, p &gt; 0.05).  Conclusiones:  la menor prevalencia de SAM en EspA + SED podría deberse a la superposición de síntomas o a la supresión mediada por tratamientos inmunomoduladores. Las diferencias en el uso de medicamentos reflejan variaciones en las estrategias diagnósticas y terapéuticas. Evaluaciones clínicas integrales son esenciales para un diagnóstico preciso y una optimización de los tratamientos en pacientes con TEH/SED y enfermedades autoinmunes asociadas.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[hypermobile spectrum disorders]]></kwd>
<kwd lng="en"><![CDATA[Ehlers-Danlos syndromes]]></kwd>
<kwd lng="en"><![CDATA[spondyloarthritis]]></kwd>
<kwd lng="en"><![CDATA[mast cell activation syndrome]]></kwd>
<kwd lng="en"><![CDATA[biologics]]></kwd>
<kwd lng="es"><![CDATA[trastornos del espectro hipermóvil]]></kwd>
<kwd lng="es"><![CDATA[síndromes de Ehlers-Danlos]]></kwd>
<kwd lng="es"><![CDATA[espondiloartritis]]></kwd>
<kwd lng="es"><![CDATA[síndrome de activación mastocitaria]]></kwd>
<kwd lng="es"><![CDATA[biológicos]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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