Abstract
Two patients with McArdle's disease had acute renal failure associated with acute rhabdomyolysis. Both patients had only mild muscular symptoms before the onset of acute rhabdomyolysis. In one case the course of acute renal failure was marked by transient hypercalcemia at the onset of the diuretic phase. In one patient no phosphorylase activity was observed, and no immunologically reactive phosphorylase was found in muscle-biopsy specimens. In the other a small amount of muscle phosphorylase (5 and 10 per cent of normal, depending on the method used) was detected by histochemical, biochemical and immunologic methods. The phosphorylase activity detected in this second patient did not remain stable, suggesting that such activity may be due to an abnormal, unstable molecule. The data suggest that more than one molecular mechanism may be involved in muscle phosphorylase deficiency.
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