With APL, a progressive loss of fat from the upper body that spares the lower body in children under the age of 16 is suggestive of a diagnosis.
[rarediseases.org]
Family history revealed similar features in her 3-year-old sister with loss of fat all over the body, protuberant abdomen since early months, poor weight gain, hyperpig mentation
[idoj.in]
[…] of fat all over the body, protuberant abdomen since early months, poor weight gain despite having voracious appetite, hyperpigmentation of the neck and the body flexures,
[idoj.in]