Acute renal failure in McArdle's disease.

A 35-year-old man had acute renal failure and was subsequently diagnosed as having rhabdomyolysis secondary to McArdle's disease, a primary myopathy due to myophosphorylase deficiency. Although it is a recognized cause of intermittent myoglobinuria, it has, nevertheless, rarely been associated with acute renal failure. The most likely explanation is that patients with this myopathy, because of mild muscle symptoms early in life, recognize their exercise limitations and thus avoid severe myoglobinuric episodes. However, unusually vigorous anaerobic muscle activity may produce myoglobinuria sufficient to cause renal damage. When acute renal failure does occur, the clinical course is similar to that of patients with other types of myoglobinuric renal failure.