 Fabry disease, FD, is a rare genetic disorder caused by a lack of the enzyme alpha galactosidase, AJL. This leads to the build-up of globitriacilceramide, GB3, which causes progressive damage to multiple organs such as the kidney, heart and nervous system. Early diagnosis is difficult due to the wide range of symptoms and signs, but once diagnosed, treatment with enzyme replacement therapy can help slow down the progression of the disease. In this case report, we present a patient who was initially misdiagnosed with other conditions before being correctly diagnosed with Fabry disease. Electron microscopy of the patient's renal biopsy revealed the presence of GB3, confirming the diagnosis. This case illustrates the importance of thorough medical history taking and careful evaluation of renal biopsies to ensure timely diagnosis of Fabry disease. This article was authored by Jugadish Jambodi and Cynthia H. Forrest. We are article.tv, links in the description below.