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March 1972


Author Affiliations

San Diego, Calif

Am J Dis Child. 1972;123(3):264. doi:10.1001/archpedi.1972.02110090134026

To the Editor.—We enjoyed the recent article by Guthrie and associates on "The 4p—Syndrome".1 We should like to point out, however, that they, as did Miller et al2 and Falk,3 noted the clinical similarity of the cri du chat (5p—syndrome) to the 4p—syndrome but failed to mention the Smith-Lemli-Opitz syndrome in the differential diagnosis. Nearly all of the common features of the 4p—syndrome listed in Fig 31 p 424 of their article are also common features of the Smith-Lemli-Opitz syndrome.4,5 We have not found enough differentiating features between these syndromes to allow for clinical separation but feel one must rely on chromosomal analysis to make this distinction.6

It is true that colobomata of the iris, midline scalp defects, and low finger ridge counts are more commonly seen in the 4p—syndrome and pedal syndactyly, ptosis of the eyelids, and

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