CASE REPORTThis boy was the 39-week product of an uncomplicated pregnancy and had no significant family history. At birth, he weighed 2.6 kg, his length was 45 cm, head circumference was 31 cm, and Apgar scores 2 to 6. There was meconium fluid present. During the neonatal period he had subcutaneous fat necrosis, confirmed by skin biopsy specimen findings, and hypercalcemia. These lesions spontaneously resolved, leaving areas of lipoatrophy.On follow-up, dysmorphic features consisting of a small head, peculiar facies, frontal bossing, micrognathia, broad nasal bridge, low-set ears, short palpebral fissures, and blepharophimosis were seen (Figs. 1 and 2). His voice was high pitched, and a thick lingual frenulum was observed. On skin examination he demonstrated keratosis pilaris, eczema on the trunk and extremities, sparse scalp hair, and two keloidal axillary lesions.The following investigations had normal results: electroencephalogram, cerebral computed axial tomography, echocardiography, electrocardiogram, chest radiograph, kidney echography, and ophthalmologic examination. Growth retardation was detected, as well as a delay in psychomotor development and behavior problems. Karyotype was normal.During this time he had several respiratory infections that required hospital admission. A low level of IgG (240 mg/dL) was detected.