Fabry disease is an X-linked recessive glycolipid storage disease. It is caused by deficiency of the lysosomal enzyme α-galactosidase A and leads to the accumulation of the enzyme substrate, globotria-sylceramide (Gb3) in many tissues including endothelial cells, pericytes and smooth muscle cells of blood vessels, renal epithelial cells, cardiac myocytes and numerous neuronal cells.

In this report, we present 20-year-old male patient with ischemic stroke in pons. The case had previously been misdiagnosed as polimyositis and vasculitis.

Angiokeratomas, neuropathic pain and ischemic stroke in young age suggested a Fabry disease. The diagnosis was confirmed biochemically and genetically.

All young adults with stroke, especially if they have additional simptoms like angiokeratomas, proteinuria, neuropathic pain in toes and fingers should be tested for Fabry disease.