Two Problems: Diagnosing the EEC/EECUT Syndrome and Recommending Dietary Fiber-Reply

Abstract

In Reply .—In my editorial commentary 1 I reaffirmed the value of the classic case report. The EEC syndrome served to illustrate this point. An astute case report 2 emphasized the involvement of the urinary tract in this disorder. This strengthened our powers of recognition and treatment, updating a genetic diagnosis. The first child in the family I saw had a split left hand and right foot, and there was a patrilineal history of cleft hand and foot. We supported the diagnosis of split hand and foot as most probable, with a recurrence risk of maximally 50%. A second child with malformations was born later into the family. The child had an indented upper lip, a cleft palate, and lateral displacement of the lacrimal puncta (telecanthus). The hands were normal. The feet were also within normal limits. I could insert my index finger between the first and second toes, which