PMC4736587_01
(a) and (b) Note the prominent forehead and cheeks, hypertelorism and broad nasal root, short stature, and abdominal distention of the child.
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fig1
As seen in the attached photo facial dysmorphism (prominent forehead, broad based nasal bridge, and hypertelorism) is evident (Figures 1(a) and 1(b)).
A one-year-old girl with failure to thrive and motor delay. Note facial dysmorphism (hypertelorism and broad nasal root).
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Two other children in the family (his cousin a one-year-old girl weighing 7 Kg with developmental delay and another cousin a 9-year-old boy weighing 16 Kg) also showed somewhat similar symptoms (Figures 2 and 3).
A nine-year-old boy with failure to thrive and abdominal distention. Note facial dysmorphism (hypertelorism and broad nasal root).
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fig3
Two other children in the family (his cousin a one-year-old girl weighing 7 Kg with developmental delay and another cousin a 9-year-old boy weighing 16 Kg) also showed somewhat similar symptoms (Figures 2 and 3).
Duodenal mucosa: (a) and (b) moderate to severe shortening of most villi (few rather tall villi are seen in picture (b)). (c) Focal superficial epithelial changes (poor gobletting, irregularity of lining cells) (intraepithelial lymphocytes: under 10/100). There is also mild to moderate infiltration of lymphoplasma cells and some eosinophils (3-7/100) in lamina propria. (d) Note crypt architectural changes.
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fig4
No giardia lamblia parasites are seen (Figure 4).
Hair shaft of the child showing kinking.
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