Childhood: endocrine (polyphagia, insatiable hunger, hypoglycemia, rapid weight gain
after 1 year of age, morbid obesity, short stature, hypogenitalism, and
hypogonadism); craniofacial (narrow bitemporal head dimension, almond-shaped
eyes with strabismus and myopia, thin upper lips with down-turned corners,
dental enamel hypoplasia and early caries, viscous saliva); neurological
(global developmental delay, skin picking, high pain threshold, behavioral
and personality problems, sleep disturbances, speech problems, hyporeflexia,
seizures); musculoskeletal (small hands and feet with tapered fingers,
hypermobile joints, scoliosis, kyphosis); respiratory (poor cough,
hypoventilation, sleep apnea, restrictive lung disease, recurrent chest
infections, hypoxia); cardiovascular system (pulmonary hypertension and cor
pulmonale secondary to chronic hypoxia, cardiac failure and arrhythmias,
primarily premature ventricular contractions); other (skin hypopigmentation,
defective temperature regulation, ischemic gastroenteritis, and gastric
dilatation). Diabetes mellitus most often is diagnosed at that time because
of high calorie intake.