We performed family studies with type II CD36 deficiency. In the Mi. Y family, the proband (YII.1) and his brother (YII.2) displayed a type II deficient phenotype. In the mother (YI.2), binding of the anti-CD36 monoclonal antibody, OKM5, to both platelets and monocytes was reduced as compared to CD36 positive control cells. In the father (YI.1), while OKM5 binding to his platelets was reduced, that of his monocytes was almost the same as normal control monocytes. Analysis of genomic DNA showed that YI.2, YII.1 and YII.2 were heterozygous for a proline90-->serine mutation, and showed that both alleles of YI.1 did not have the mutation. Analysis of CD36 cDNA showed that the Pro90 form of CD36 cDNA could be detected in monocytes, but not in platelets from YII.1 and YII.2. These data indicated that YII.1 and YII.2 could be compound heterozygotes; an allele having a platelet-specific mRNA expression defect(s), which was responsible for the different CD36 expression between their platelets and monocytes, and the Ser90 allele. YI.1 was suggested to be a carrier of the platelet-specific silent allele. The platelet-specific silent allele was linked to a specific genotype of a polymorphic microsatellite sequence in the CD36 gene, supporting our hypothesis that mRNA expression defect(s) occurred at or near the CD36 gene. In a second type II CD36 deficient family, we also obtained results consistent with this hypothesis.