Al-Gazali et al. (2003) reported a female child born to Tunisian second cousins. She had several dysmorphic features at birth including bossing of the forehead, a depressed nasal bridge, small dysmorphic ears and edema of the dorsum of hands and feet. At three months of age she presented with a wide anterior fontanel, a prominent forehead with an open metopic suture, widely spaced eyes, a very flat and depressed nasal bridge, thin tented lips, small dysmorphic ears and preauricular skin tags. She was treated for diarrhea in the first two months of life and also had persistent vomiting. At her first year of age, she was hypotonic with delayed milestones and had a bilateral severe conductive hearing loss.

Al Gazali et al. (2003) described several Arab children with Hennekam syndrome. One of these was a male child of first cousin parents from the United Arab Emirates. At birth he was noted to have puffy face with marked edema of the hands, lower legs, and dorsum of the feet, more on the left side than the right side. At two months of age, he was admitted to hospital because of abdominal swelling. Since that time, he underwent repeated hospitalizations for shortness of breath and prolonged expiration on auscultation. At nine years, he presented a prominent occiput, widely spaced eyes, epicanthic folds, a flat face with a depressed nasal bridge and a short nose, poor dental hygiene and a high, arched palate.

Alders et al. (2013) studied CCBE1 gene mutations in a cohort of patients with lymphadema. An Emirati male patient without a mutation in CCBE1 but in whom the diagnosis HS was considered to be likely, was included in this report. 

Alders et al. (2013) studied CCBE1 gene mutations in a cohort of patients with lymphadema. A Yemeni female patient without a mutation in CCBE1 but in whom the diagnosis HS was considered to be likely, was included in this report.