Ehlers­Danlos syndrome and anorexia nervosa: a dangerous combination?

A 16-year-old boy with anorexia nervosa and Ehlers­Danlos syndrome presented with spontaneous pneumomediastinum and bradycardia.Although prior occurrences of pneumomediastinum and visceral perforations have been reported in adolescents with isolated anorexia nervosa or Ehlers­Danlos syndrome, to our knowledge this is the first instance to be noted in a patient with both conditions.We explore several possibilities regarding the etiology of his mediastinal air, but ultimately conclude that it was the existence of Ehlers­Danlos syndrome in the presence of anorexia nervosa that led to the development of this dangerous condition.