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Updated: Dec 28, 2025

In Vitro Enzyme Measurement to Test Pharmacological Chaperone Responsiveness in Fabry and Pompe Disease
Published on: December 20, 2017
Diagnosis and Care of Infants and Children with Pompe Disease
Andreas Hahn1, Julia B Hennermann2, Martina Huemer3
1Zentrum für Kinderheilkunde und Jugendmedizin der JLU Gießen, Abt. Neuropädiatrie, Sozialpädiatrie und Epileptologie - Sozialpädiatrisches Zentrum, Gießen, Germany.
Insights
Pompe disease, a rare metabolic myopathy, requires updated care strategies. This review covers new knowledge on pediatric Pompe disease diagnostics, treatment, and follow-up, including enzyme replacement therapy (ERT) challenges.
Area of Science:
- Biochemistry
- Genetics
- Pediatric Medicine
Background:
- Pompe disease is a rare metabolic myopathy due to lysosomal α-glucosidase deficiency.
- Glycogen accumulation impairs cellular function and autophagy, with disease severity linked to residual enzyme activity.
- Enzyme replacement therapy (ERT) has improved survival, particularly in infantile-onset cases, revealing new long-term challenges.
Purpose of the Study:
- To review recent advancements in the care of pediatric Pompe disease patients.
- To provide updated recommendations for the diagnosis, treatment, and follow-up of this condition.
- To address emerging issues such as antibody formation against ERT.
Main Methods:
- Literature review of recent scientific publications and clinical data.
- Synthesis of current knowledge on Pompe disease pathophysiology and management.
- Development of evidence-based recommendations for clinical practice.
Main Results:
- Prolonged survival in infantile Pompe disease has unveiled novel phenotypes and complications.
- Antibody formation against recombinant enzyme therapy can negatively impact treatment response.
- New insights into disease management necessitate updated diagnostic and therapeutic approaches.
Conclusions:
- Comprehensive and updated care strategies are crucial for pediatric Pompe disease.
- Monitoring for ERT-related antibodies and managing new phenotypes are key concerns.
- Continued research and clinical vigilance are essential for optimizing patient outcomes.
Abstract:
Pompe disease is a rare metabolic myopathy caused by deficiency of lysosomal α-glucosidase. Reduced enzyme activity results in abnormal intra- and extralysosomal glycogen deposition as well as impaired cellular function and autophagy. Age at manifestation and severity of disease depend on residual enzyme activity. Enzyme replacement therapy (ERT) is available since 2006. In infantile onset Pompe disease, the most severe form, markedly prolonged survival has resulted in a new phenotype with symptoms and problems not encountered previously. In addition, it became apparent that antibody formation against the recombinant human enzyme may adversely affect the response to ERT. This review summarizes new knowledge gained in the last years concerning care of pediatric patients with Pompe disease and gives recommendations for diagnostics, treatment, and follow-up.
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