A five month old girl with exocrine pancreatic insufficiency, skeletal deformities and a non constant neutropenia (Shwachman's syndrome) is presented. Infectious complications, mainly septic and pulmonary, which caused her death, were frequent. The pathologic findings showed a pancreatic lipomatous hypoplasia and absence of zymogen granulos, as well as anomalies of the growing cartilage where no radiological abnormalities could be seen.