respiratory infections;HP:0002564 Malformation of the heart and great vessels;HP:0002648 Abnormality of calvarial morphology;HP:0002650 Scoliosis;HP:0002974 Radioulnar synostosis;HP:0003042 Elbow dislocation;HP:0003043 Abnormality of the shoulder;HP: [pediascape.org]

[…] teeth;HP:0000689 Dental malocclusion;HP:0000717 Autism;HP:0000771 Gynecomastia;HP:0001250 Seizures;HP:0001252 Muscular hypotonia;HP:0001337 Tremor;HP:0001382 Joint hypermobility;HP:0001513 Obesity;HP:0001763 Pes planus;HP:0001883 Talipes;HP:0002019 Constipation [pediascape.org]

Extraoral examination revealed retruded mid face with mandibular prognathism [Figure 1]. Figure 1: (a) Preoperative extraoral photograph showing mandibular prognathism. [jcd.org.in]

[…] also reflect ascertainment bias, however, because many cases previously studied were found in institutions for juvenile delinquents. 49,XXXYY has been reported at least twice. 103, 104 Both patients had mental retardation, delayed bone age, mandibular prognathism [glowm.com]

Affected males show a normal to tall stature with a decreased upper segment to lower segment ratio, hypertelorism and epicanthic folds, simplified ears and mild prognathism, skeletal anomalies including clinodactyly, abnormalities of the elbows and radioulnar [karger.com]

He had delayed dentition and speech and started walking at 2 years of age. He developed a peculiar gait, always keeping both his elbows flexed and wrist extended and hands in pronation. [childhood-developmental-disorders.imedpub.com]

[…] asymmetry;HP:0000388 Otitis media;HP:0000470 Short neck;HP:0000486 Strabismus;HP:0000581 Blepharophimosis;HP:0000582 Upslanted palpebral fissure;HP:0000670 Carious teeth;HP:0000679 Taurodontia;HP:0000682 Abnormality of dental enamel;HP:0000684 Delayed eruption [pediascape.org]

Bendy (hyperextensible) joints and flat feet are common. The parents of a son with 48,XXXY almost always have normal chromosomes in their body’s cells, so they are not routinely tested. [gagesstory48syndrome.weebly.com]

joints, and underdeveloped genitalia with hypergonadotropic hypogonadism [Visootsak et al., 2007]. [karger.com]

He had mild hypertelorism, flattened nasal bridge, slightly pronounced chin, inverted right nipple, small penis, small hands and mild generalized hypotonia. [ijponline.biomedcentral.com]

Many people respond with guilt, fear, or blame when a genetic disorder is diagnosed in the family, or they may overprotect the affected member. [healthofchildren.com]

His grandmother requested psychiatric admission as she was fearful for him. During evaluation he endorsed suicidal ideation but denied any intent or plan. [childhood-developmental-disorders.imedpub.com]

Boys and men with 48,XXXY syndrome tend to have anxiety, a short attention span, and impaired social skills. 48,XXXY syndrome is also associated with weak muscle tone (hypotonia) and problems with coordination that delay the development of motor skills [ghr.nlm.nih.gov]