Several aspects of purine metabolism were studied in peripheral blood mononuclear cells and fibroblasts from a patient with purine nucleoside phosphorylase deficiency and compared to cells from normal controls. Intact cells were incubated with radioactive purine bases and all purine metabolites were extracted and analyzed. Incubation of purine nucleoside phosphorylase-deficient cells with [3H]hypoxanthine and [3H]guanine resulted in the accumulation of large proportions of the incorporated radioactivity into inosine (60-80%) and to lesser extent into guanosine (15-30%), respectively, whereas normal cells accumulated only minor amounts of inosine and guanosine. This observation indicates that purine nucleoside phosphorylase, together with hypoxanthine-guanine phosphoribosyltransferase and nucleoside monophosphate phosphatase, participate in remarkably active inosine and guanosine cycles. These purine nucleoside cycles may play a role in the regulation of intracellular purine nucleotide levels. The absence of these cycles in purine nucleoside phosphorylase-deficient patients may be detrimental to the differentiation of lymphocytes.