case_images: PMC4736587_01
case_images: (a) and (b) Note the prominent forehead and cheeks, hypertelorism and broad nasal root, short stature, and abdominal distention of the child.
case_images: CRIPA2016-9684910.001.jpg
case_images: PMC4736587_01_CRIPA2016-9684910.001.jpg
case_images: fig1
case_images: As seen in the attached photo facial dysmorphism (prominent forehead, broad based nasal bridge, and hypertelorism) is evident (Figures 1(a) and 1(b)).
case_images: A one-year-old girl with failure to thrive and motor delay. Note facial dysmorphism (hypertelorism and broad nasal root).
case_images: CRIPA2016-9684910.002.jpg
case_images: PMC4736587_01_CRIPA2016-9684910.002.jpg
case_images: fig2
case_images: 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).
case_images: A nine-year-old boy with failure to thrive and abdominal distention. Note facial dysmorphism (hypertelorism and broad nasal root).
case_images: CRIPA2016-9684910.003.jpg
case_images: PMC4736587_01_CRIPA2016-9684910.003.jpg
case_images: fig3
case_images: 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).
case_images: 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.
case_images: CRIPA2016-9684910.004.jpg
case_images: PMC4736587_01_CRIPA2016-9684910.004.jpg
case_images: fig4
case_images: No giardia lamblia parasites are seen (Figure 4).
case_images: Hair shaft of the child showing kinking.
case_images: CRIPA2016-9684910.005.jpg
case_images: PMC4736587_01_CRIPA2016-9684910.005.jpg
case_images: fig5