Dear Doctor This is regarding my 9 months old daughter, who, at the time of birth was diagnosed with hypotonia, hyperflexibility of joints and cynosis. Now she is having developmental delays and poor muscle tone. She smiles but can not sit without support. The neck holding has come just a month back. She has short limbs, funnel shaped chest, small & inverted nipples. Her blood chemistry is as below. 1. Free T3 - 2.27 pg/ml 2. Free T4 - 0.92 ng/dl 3. TSH (Third generation) - 2.03 ulU/ml 4. Serum Calcium (Conventional)- 0.7 mg/dl 5. Alkaline Phosphatase(Conventional) - 229.00 U/l 6. Phosphorus (Conventional) - 14.40 mg/dl 7. Red Cell Count - 2.95 10^12/l 8. Hemoglobin - 7.1 g/dl 9. Hematocrit - 21.50 % 10. MCV - 72.90 fl 11. MCH - 24.10 pg 12. Lymphocytes - 55.00 % 13. RBC - Mild anisopoikilocytosis. Predominantly microcytic hypochromic with ovalocytes. 14. WBC - Eosinophilia present Her skeletal survey is normal. EMG and NCV is normal. 2D echo of the heart is normal. She is hving motor delays and excessive sweating in the head. She vomits too often and is having a narrow face. Can we pin point the syndrome she is having or she is having some nutritional/vitamin deficiency???