This 1.8 yr old kid, muslim boy came to  the OPD very lethargic, and obvious failure to thrive. He had fever and LRI with a history of 3 days constipation. He could walk, and sit and stand from squatting position. No other family history of failure to thrive or early deaths.

Heart and CNS is normal. chest had few crackles,fine. Abdomen was distended, soft and there was no organomegaly.USS abdomen was normal. His calcium, Pos and ALk Pos was normal.