Editor—Little is still known about the long term outcome of the rare, progeria-like disorder of Mulvihill-Smith syndrome (McKusick 176690). In 1994 we described the clinical progress of a patient (fig 1) up to the age of 20 years.1 The patient had facioskeletal and dental abnormalities, severe viral infections, allergic rhinitis and conjunctivitis, visual loss, delayed puberty, modest achievement at school, and reactive depression. We now report the clinical course until his death.

He attended office clerk training for physically handicapped people but had coordination …