Table 1.

Clinical symptoms of MPS II.

Feature	Symptoms
Anthropological abnormalities	Normal or high birth weight and body length, growth inhibition from the age of 3 years and then short stature, growth deficiency, macrocephaly [12,15]
Dysmorphic abnormalities	Thickened facial features, broad nose, large head circumference, thick hair with a low neckline [3,8]
Rheumatological/orthopedic abnormalities	Reduced range of joint motion, dysostosis multiplex visible on X-ray examinations, carpal tunnel syndrome, ultrasonographic features of hip joints [16,17,18,19]
Laryngological abnormalities	Enlarged tongue, hypertrophic tonsils, slurred speech over time, gingival overgrowth, widely spaced teeth, recurrent middle-ear infections, progressive hearing loss [3,8]
Pulmonological abnormalities	Recurrent upper respiratory tract infections and pneumonia, progressive airway obstruction, sleep apnea [3,8]
Cardiological abnormalities	Valvular thickening and regurgitation, cardiomyopathy
Gastrointestinal/surgical abnormalities	Liver or liver and spleen enlargement, diarrhea, inguinal and umbilical hernias [3,8]
Neurological and developmental abnormalities	Behavioral disorders, poor/lack of concentration, hyperactivity, various degrees of mental retardation [3,8]