A genetic defect was investigated in a newly diagnosed Japanese case with muscle type phosphofructokinase (PFK-M) deficiency. Polymerase chain reaction (PCR) amplification of patient cDNA revealed an in-frame truncation of 165 bases. This was compatible to the complete deletion of exon 19. The rest of the sequence was identical to that of the normal PFK-M cDNA. Sequencing of PCR amplified genomic DNA of the patient revealed a point mutation from G to A at the 5' donor site of intron 19. This mutation resulted in the skipping of exon 19 in the patient mRNA. Homozygosity of this patient was confirmed by allele specific amplification of the genomic DNA. Donor mutations in intron 15 and intron 5 associated with different splicing errors were previously reported to cause this disease. Thus, the human PFK-M gene mutations are heterogeneous, however, the donor mutations and splicing errors would represent one of the frequent causes of this disease.