Farag and Teebi (1990) described three brothers suffering from hypertelorism, hypospadias, and tetralogy of Fallot. They were born to Arab first cousins once removed and their father suffered from evident hypertelorism. A paternal uncle who was described as normal was married to a second cousin and had a daughter with hypertelorism and tetralogy of Fallot. The four patients (3 male sibs and a female cousin) demonstrated early cyanosis, feeding problems, hypertelorism, epicanthic folds, narrow palpebral fissures, flat nasal bridge, dysmorphic pinna, hypospadias, tetralogy of Fallot, further cardiac defects, and mild mental retardation. Farag and Teebi (1990) proposed that the combination of abnormalities might have symbolized a formerly un-described autosomal recessive disease.