Renal tubular acidosis is a relatively rare but well documented disorder of renal acidification in which both the rate and concentration of acid excretion are subnormal during metabolic acidosis. The report of Morris and Fudenberg1 has called attention to the association of hyperglobulinemic states which defects in urine acidification. In this regard, we have recently studied a patient with inability to acidify the urine, adult Fanconi syndrome, γ-globulinuria, and a primary myopathy. To the best of our knowledge, this combination has not been previously described.
A 57-year-old Negro man was admitted to Multnomah Hospital Sept 1, 1966, with a four year history of progressive weakness of his legs. The patient stated that he had difficulty stepping up onto a curb or arising from a kneeling position and, in addition, had shortened his stride because of a subjective impression that he could not adequately support his weight. Two