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* Soft tissue swelling of internal organs, notably the heart with the attendant weakening of its muscularity, and the kidneys, also the vocal cords resulting in a characteristic thick, deep voice and slowing of speech
* Generalized expansion of the skull at the fontanelle
* Pronounced brow protrusion, often with ocular distension (frontal bossing)
* Pronounced lower jaw protrusion (prognathism)

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