We report a case of long-standing SLE which presented with symptomatic musc
le vasculitis on a background of photosensitivity, arthralgia and myalgia T
he diagnosis was complicated by cardiomyopathy, nephrotic syndrome and diab
etes. We highlight the benefits of aggressive treatment in severe disease a
nd the importance of recognising and treating comorbidity especially in rel
ation to atherosclerosis.