Misdiagnosis Somatization disorder

Somatization disorder is standard content of medical education. An example of an exam question:

A 40-year-old patient repeatedly comes to your practice with changing physical symptoms. In the beginning, the focus was on gastrointestinal complaints, such as nausea, flatulence and abdominal pain. The investigations of the gastro-intestinal tract yielded no organic findings.

Four weeks later, the patient complains of frequent palpitations and tightness in the chest, outbreaks of sweating and physical exhaustion. Here, too, there are no organic findings in the cardiological examination.

The patient later presents to your practice with general muscle pain that has been present for several months and reports that she is often on sick leave because of the pain and that the employer is already putting pressure on her.

She states that the symptoms have existed for as long as she can remember and none of the doctors she has consulted have found anything, even though she is feeling so bad. She has the impression that no one wants to help her. The only medicine (Tavor) that gave her some relief, no doctor wants to prescribe her anymore. She has already taken advantage of psychotherapy, but has not experienced any improvement as a result.

Which suspected diagnosis should be made here in the first place?

Somatization disorder is expected as the correct answer.

This example describes a doctor odyssey that many Fabry patients experience day by day.