**5. Initiation of ERT**

Initiation of ERT requires a fully confirmed diagnosis of Fabry disease [19]. The patient/patient's family should be included in the decision-making process and should have a good understanding of the impact of the treatment as well as potential adverse reactions. The initiation of lifelong ERT infusion therapy is a major decision with important implications for both the patient, particularly the pediatric patient, and the family [42]. Treatment and follow-up assessments should ideally be led by a physician who is experienced in the management of patients with Fabry disease, with support from a multidisciplinary clinical team including nephrology, cardiology, medical genetics, neurology, psychology, and nursing [19].
