[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
Citations 0
Special Feature
October 1999

Picture of the Month

Author Affiliations

From Sinai First, Chicago, Ill (Dr Rais Dana); and The American Board of Pediatrics, Chapel Hill, NC (Dr Tunnessen).



Arch Pediatr Adolesc Med. 1999;153(10):1105-1106. doi:10.1001/archpedi.153.10.1105

A 2-MONTH-OLD INFANT was referred for evaluation of poor weight gain, a weak suck, and hypotonia. The infant was the product of a full-term pregnancy during which the mother received no prenatal care, and was delivered by cesarean section because of a breech presentation. The birth weight was 3300 g. The parents were second cousins and had had a previous stillborn infant with facial dysmorphogenesis.

On physical examination the infant was alert but extremely hypotonic. Dysmorphic features included a high forehead, flat, broad nasal bridge, micrognathia, and a high arched palate (Figure 1). The sucking response was poor. The fontanels were large and the liver was palpable 3 cm below the right costal margin (Figure 2). The left testis was cryptorchid.