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How does Ehlers-Danlos syndrome increase the risk of bleeding?

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Fibrin in blood clotting — bleeding and blood clotting Red blood cells (erythrocytes) trapped in a mesh of fibrin threads. Fibrin, a tough, insoluble protein formed after injury to the blood vessels, is an essential component of blood clots.

Ehlers-Danlos syndrome (EDS) increases the risk of bleeding primarily due to its nature as a disorder of collagen synthesis. Collagen is a vital structural protein that provides tensile strength and integrity to tissues, including the walls of blood vessels.21

In individuals with EDS, the abnormal organization or synthesis of collagen bundles leads to increased fragility of these vessels. Because the vessel walls are structurally weakened, they are prone to rupture even from minor injuries, which can cause severe bleeding and lacerations that tend to extend. Additionally, the skin of affected individuals is often fragile and bruises easily, further contributing to the clinical tendency toward hemorrhage. In some severe cases, the condition may even lead to the rupture of major blood vessels.3241