Consultant Physician

SUMMARY: A case of systemic lupus erythematosis (SLE) affecting the heart, joints, skin and kidneys is reported. Antinuclear antibodies were insignificant at presentation. Diagnosis was only possible with passage of time and renal biopsy. Case Report A 26 year old male caucasian who was fit enough to pass the Basic Fitness Test in 9 minutes presented with left shoulder pain which developed whilst on holiday in Hawaii in June 1988. Chest pain, shortness of breath and palpitations caused his hospital admission from exercise in October 1988. On examination, he had a faint erythematous rash affecting the dorsum of both hands and forearms. Jug-ular venous pressure was elevated, but there was no dependent oedema, nor hepatosplenomegaly. Blood pressure was 125/80 mm Hg with no paradox. He ha