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)