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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 Fudenberg 1 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. Patient Summary 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