Bardet-Biedl syndrome (BBS) is a rare, autosomal recessive genetic disorder. Polydactyly, obesity, pigmentary retinal degeneration, intellectual disability, kidney abnormalities and hypogonadism are common features. We report an infant who presented with obesity, micropenis, polydactyly and syndromic features, raising suspicion of a genetic syndrome. Infantile obesity is among the most common clinical findings in BBS. Whole-exome sequencing confirmed a mutation in the BBS4 gene which was homozygous and associated with BBS. The child was discharged in stable condition after 11 days of hospitalisation. On follow-up after 2 years of age, setmelanotide is planned to be initiated for his weight management. Infantile obesity, a rare and early manifestation, played a pivotal role in suspecting syndromic obesity, leading to targeted genetic investigations. The case highlights the importance of recognising early-onset obesity as a diagnostic clue for genetic syndromes by performing next-generation sequencing critical to make firm diagnosis of BBS.
Akhila et al. (Thu,) studied this question.