Chronic Fatigue Syndrome through Postural Orthostatic Tachycardia Syndrome to Hypermobile Ehlers Danlos Syndrome: a Journey Through Unclear Diagnoses

An active teenage athlete develops acute and prolonged debilitating fatigue prohibiting attendance at school and sports. Extensive evaluation leads to initial suspicion of Chronic Fatigue Syndrome (CFS). The collaboration of patient, family and physician further refined the diagnosis as arising from Postural Orthostatic Tachycardia Syndrome (POTS) and eventually Ehlers Danlos Syndrome (EDS). Non-specific symptoms, like fatigue, uncommon diagnoses, like POTS and EDS, frustrate both physicians and patients alike and can lead to resentment on both sides. Lack of simple hematologic or radiographic tests for such diagnoses impedes not only rapid diagnosis but also understanding of the disease process. Familiarity with these pathologies and their interplay enable clinicians to more readily entertain them in a differential diagnosis. The collaborative journey taken by the patient, family and physician is as essential to the overall well-being of all involved.