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In absence of the possibility of genetic tests, the exact cause of Merrick's deformities has long been unclear, so that throughout much of the 20th century it was speculated that Merrick was affected by other neurological syndromes. Only in 1986 was it conjectured that he had Proteus syndrome, a very rare congenital disorder also known as Wiedemann syndrome (named after the German pediatrician Hans-Rudolf Wiedemann). DNA tests on his hair and bones in 2003 in a study by Charis Eng were inconclusive.