A 14-year-old boy with exercise-related myalgia and cramps had several
episodes of myoglobinuria since early childhood. An episode at 2 year
s of age caused acute renal failure. Histochemical and biochemical ana
lysis of muscle showed a combined defect of phosphofructokinase (PFK)
and adenosine monophosphate (AMP) deaminase. DNA analysis showed that
the patient was homozygous for a G-to-C substitution at codon 39 of th
e PFK gene (previously described in an Italian patient) and for the co
mmon mutation found in AMP deaminase deficiency.