In addition, comorbidities such as gastrointestinal, endocrinal, pulmonary involvement are reported in literature, with high incidence of severe metabolic anomalies.9The failure to thrive and chronic non-infectious diarrhea, observed in severe NS forms, might be partly related to abnormal digestive permeability and absorption as SPINK5 mRNAs are expressed in the gastrointestinal tract.19, 20. This evidence concerns the gene SPINK5 and Failure to thrive.