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In page Kocher–Debre–Semelaigne syndrome:
"The age at which a child presents with KDSS may vary from new born to as late as 11 years of age.[1] This disease is very rare as only less than 10% of children with hypothyroid myopathy develops this condition.[citation needed] Along with features of hypothyroidism (such as lethargy, slow heart rate, cold intolerance, dry skin, and hoarse voice) the main additional feature is muscle hypertrophy. It can happen in any muscle of the limbs, but commonly affects the calf muscles, giving the typical Herculean appearance.[1]
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