Reviewer ’s report  
 
Title: A PTPN11 Mutation in a Woman with Noonan Syndrome  and Protein -Losing Enteropathy  
 
Version: 0 Date: 09 Dec 2019  
 
Reviewer: Shinichi Morita  
 
Reviewer's report:  
 
This case is a report of protein losing enteropathy of Noonan syndrome, and considered as a 
valuable report.  
 
However, I would like you t o consider the following points.  
 
1. In this case, dietary therapy has been useful for reducing edema.  
 
Please consider dietary treatment for protein losing enteropathy (low fat diet, etc.)  
 
 
2. Endoscopic images are not enough quality and the snowflake appe arance that the author 
considers important is unclear. Please improve image quality and point important findings with 
arrows. Please use the arrows etc. for CT images to match the findings and figure legends.  
 
 
3. In figure2, the patient number of II2 is in correct. Also, please add a description of the gene 
mutation part so that it is easier to understand.  
 
I think that it is necessary to add explanation also about figure3.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary control s? 
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financially from the 
publi cation of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publication of this manuscript, either now or in the 
future?  
 
3.  Do you hold or are you curr ently applying for any patents  relating to the content 
of the manuscript?  
 
4.  Have you received reimbursements, fees, funding, or salary from an organization 
that holds or has applied for patents relating to the content of the manuscript?  
 
5.  Do you have any  other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understan d that my name will be incl uded 
on my report to the authors and, if the manuscript is accepted for publication, my named repo rt 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understan d that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: A PTPN11 Mutation in a Woman with Noonan Syndrome  and Protein -Losing Enteropathy  
 
Version: 0 Date: 09 Dec 2019  
 
Reviewer: Shinichi Morita  
 
Reviewer's report:  
 
This case is a report of protein losing enteropathy of Noonan syndrome, and considered as a 
valuable report.  
 
However, I would like you t o consider the following points.  
 
1. In this case, dietary therapy has been useful for reducing edema.  
 
Please consider dietary treatment for protein losing enteropathy (low fat diet, etc.)  
 
 
2. Endoscopic images are not enough quality and the snowflake appe arance that the author 
considers important is unclear. Please improve image quality and point important findings with 
arrows. Please use the arrows etc. for CT images to match the findings and figure legends.  
 
 
3. In figure2, the patient number of II2 is in correct. Also, please add a description of the gene 
mutation part so that it is easier to understand.  
 
I think that it is necessary to add explanation also about figure3.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary control s? 
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financially from the 
publi cation of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publication of this manuscript, either now or in the 
future?  
 
3.  Do you hold or are you curr ently applying for any patents  relating to the content 
of the manuscript?  
 
4.  Have you received reimbursements, fees, funding, or salary from an organization 
that holds or has applied for patents relating to the content of the manuscript?  
 
5.  Do you have any  other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understan d that my name will be incl uded 
on my report to the authors and, if the manuscript is accepted for publication, my named repo rt 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understan d that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: A PTPN11 Mutation in a Woman with Noonan Syndrome  and Protein -Losing Enteropathy  
 
Version: 0 Date: 09 Dec 2019  
 
Reviewer: Shinichi Morita  
 
Reviewer's report:  
 
This case is a report of protein losing enteropathy of Noonan syndrome, and considered as a 
valuable report.  
 
However, I would like you t o consider the following points.  
 
1. In this case, dietary therapy has been useful for reducing edema.  
 
Please consider dietary treatment for protein losing enteropathy (low fat diet, etc.)  
 
 
2. Endoscopic images are not enough quality and the snowflake appe arance that the author 
considers important is unclear. Please improve image quality and point important findings with 
arrows. Please use the arrows etc. for CT images to match the findings and figure legends.  
 
 
3. In figure2, the patient number of II2 is in correct. Also, please add a description of the gene 
mutation part so that it is easier to understand.  
 
I think that it is necessary to add explanation also about figure3.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary control s? 
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financially from the 
publi cation of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publication of this manuscript, either now or in the 
future?  
 
3.  Do you hold or are you curr ently applying for any patents  relating to the content 
of the manuscript?  
 
4.  Have you received reimbursements, fees, funding, or salary from an organization 
that holds or has applied for patents relating to the content of the manuscript?  
 
5.  Do you have any  other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understan d that my name will be incl uded 
on my report to the authors and, if the manuscript is accepted for publication, my named repo rt 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understan d that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant