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A 9-year-old boy presented with an 18-month history of faltering growth, recurrent respiratory tract infections, persistent ‘apthous’ ulcer on his tongue and ‘warts’ on his fingertips and soles.
He is the second offspring of a healthy unrelated Sri Lankan couple and past medical history was unremarkable. Baseline immunology and infectious disease screen were negative. On close questioning the patient had …
Competing interests None.
Patient consent Parental/guardian consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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