PLE-1581

A 5-year-old boy has distinctive coarseness in his facial features, including a prominent forehead, a nose with a flattened bridge, and an enlarged tongue. There are developmental delays and nervous system problems. Biochemical testing reveals there is a defect in the degradation of dermatan sulfate and keratan sulfate. Genetic testing shows there is a polymorphism in the gene encoding for iduronate-2-sulfatase. What is the most likely condition that the patient has?