Waleed Al Busairi and Fawzi Ali1 describe a 15-year-old boy with mental retardation and a history of putting inedible objects into his mouth. The authors might want to investigate for Smith-Magenis syndrome if this has not previously been considered.
Smith-Magenis syndrome is associated with mental retardation, sleep disturbances, few facial dysmorphic features, self-injurious behaviour and putting objects into orifices. This trait of bodily insertions is known as polyembolokoilamania.2 The definitive diagnosis is based on absence of the 17p11.2 region (a band on the short arm of chromosome 17), determined by cytogenetic examination (in more than 95% of cases2,3) or by fluorescence in situ hybridization (also known as FISH).
Chitra Prasad Medical Genetics Program of Southwestern Ontario London Health Sciences Centre London, Ont.