Joint hyperlaxity is noted in six of nine children. Almost all children have hand abnormalities, including clinodactyly, polydactyly, small fifth fingers, fetal finger pads, prominent interphalangeal joints, and distal phalanges. Three of eleven patients have cardiac defects, namely atrial septal defect and mitral valve prolapse. Six of nine patients have had gastro-intestinal problems, including esophageal reflux disease, frequent vomiting, and constipation. Most of the children have recurrent infections, including upper respiratory tract and urinary tract infections. Sleep problems are present in five of eleven patients, with good response on melatonin. Several patients are obese. Eight patients have had brain imaging by MRI. Five of them showed abnormalities, including atypical white matter lesions, wide ventricles, and choroid cysts. Behavioral problems are common. Two children were reported to have anxiety problems, three have an obsessive compulsive disorder and two have affectional problems. One of them shows aggressive behavior.
