Sir.—Marks and Bergeson (Am J Dis Child 131:447,1977) have reviewed the literature on the Silver and Russell syndromes and conclude that the reported cases are variants of the same syndrome. Since I have been a vocal advocate of the opposite point of view,1,2 it seems only fair that I should point out that Cumming et al3 have effectively spiked my cannons by a long-term follow-up of one of my reported patients. That patient and a sibling were shown to have the syndrome of mulibrey nanism.
This admission, however, leads to consideration again' of case reports of the familial occurrence of the Silver-Russell syndrome (references 17, 22, 36, and 37 of Marks and Bergeson). Such reports may be examples of the "3-M"4,5 or mulibrey nanism3,6 syndromes. Further, the report of Cumming et al3 answers the query of Smith and associates,7 who stated "we have
GLENN C. SZALAY. The Silver-Russell Syndrome. Am J Dis Child. 1977;131(9):1035. doi:10.1001/archpedi.1977.02120220101019