Some common complains can be missed by the pediatrician. Not every LSD will have the dysmorphic feature that you see in the books. Children with recurrent upper respiratory infection or otitis media in the first year of life that require lots of tubes, with heavy breathing and constant drooling, with tonsillectomy, adenoidectomy, umbilical hernia and inguinal hernia. If you have this triad of otitis media , tonsillectomy, adenoidectomy and umbilical hernia, think of an LSD and more specifically one of the MPSs.

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