Dear Colleague, Dear Colleague,
I met the young Eugenia ERILLARD born on 26/07/2010, 8 years old, who has been followed since early childhood for learning difficulties with obesity issues currently improving. 
Eugenia is the eldest of the couple, with a younger sister born in 2017 who is undergoing exploration for a possible autism spectrum disorder. 
The father has three boys from a first marriage, apparently in good health. He himself is being followed for a history of cardiac arrhythmia. There are no very specific antecedents in his family. 
The mother also had some learning difficulties in childhood. She has had several fractures, each time related to high-energy trauma. She is an only child. There are no very specific antecedents in her family. 
I was able to meet Eugenia with her two parents. 
Eugenia was born at 42 GA with the need for assistance by vacuum extraction. Birth weight was 3 kg 100, height 48.5 cm, and a HC of 35 cm. The Apgar score was 2 then 4. She had to undergo resuscitation and was hospitalized in neonatal intensive care for 2 weeks. Poor adaptation to extrauterine life, perinatal asphyxia with hemodynamic instability was noted. She also had functional kidney failure which regressed. 
At that time, the EEG was normal, as was the cerebral MRI. 
Subsequently, motor acquisitions were slightly delayed, with sitting acquired at 10 months and walking at 20 months. 
Follow-up by CDC was established. The pediatric neurologist noted simple motor delay with favorable evolution at 34 months without specific disorders. 
She currently benefits from weekly psychomotor therapy and speech therapy. She still presents some difficulties with attention, fine motor skills, and pronouncing long words. But overall, there are regularly significant improvements. 
On the health record, we clearly see overweight appearing from the age of 5. The maximum weight was noted at +5.5 SD while other parameters were at +1.5 and +2 SD for height and head circumference respectively. The parents note that she has compulsive eating episodes. 
She wears glasses for hyperopia. 
During the consultation, Eugenia is well engaged, very smiling, and expresses herself well. 
Her weight has now dropped to 40 kg, which is +3 SD, with a height of 1.35 m at +1 SD and a HC of 54.5 cm at +2 SD. The extremities are rather short. I do not find any very specific morphological elements. The neurological examination is also normal. 
In total, moderate motor and learning disorders with a history of perinatal anoxia but no signs on the associated cerebral MRI with obesity improving. 
As a principle, I requested a study of fragile X and DNA chip analysis to rule out a chromosomal micro-remodeling. 
I am not sure how much further to go if these results are normal. 
Remaining at your disposal and with the expression of my devoted sentiments.