Review Question - QID 214982

A 22-year-old man presents to his primary care physician with a 3-year history of increasing low back and knee pain. He says that he first noticed the pain in college but that it has worsened since he started a desk job after graduation. He denies fever, chills, or rashes but endorses dark urine, which he says has been present since birth. Physical exam reveals that the sclera of his eyes, and pinna of his ears have a bluish tinge. Which of the following mechanisms is most likely associated with the cause of this patient's symptoms?