Membranous nephropathy induced by enzyme replacement therapy (ERT)

A new cause of membranous nephropathy, a renal disease induced by formation of immune deposits in the renal glomerulus, has been identified in a child with Pompe disease treated with recombinant arylsulfatase. ERT could be resumed after tolerance induction therapy.​This case indicates that a mechanism of allo-immunization against the recombinant enzyme can occur in patients without residual enzyme activity (owing to genetic mutation) treated by ERT. Monitoring of renal parameters should become mandatory in these patients.​

Debiec et al. Journal of the Amercian Society of Nephrology: 25, 2014​ (in press)