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Review Question - QID 214434

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QID 214434 (Type "214434" in App Search)
A 1-year-old boy is brought to the emergency department by his parents after he fell at home. His parents say that he was attempting to walk when he slipped and fell from standing height. He was adopted from abroad at birth so his family history is unknown. On presentation, he is found to have to have bilateral midshaft femur fractures. Physical exam shows a crying child with prominent choroidal veins and deformities of both legs. No burns, bruises, or abnormal injuries are noted otherwise. Skeletal survey reveals multiple fractures in various stages of healing. Which of the following is most likely responsible for this patient's symptoms?